RACIONAL: O uso de telas cirúrgicas para a correção de defeitos da parede abdominal vem ocupando cada vez mais espaço nas operações no mundo todo. OBJETIVO: Estudar duas telas cirúrgicas distintas (Proceed® e Ultrapro®) na cicatrização de defeito produzido em parede abdominal de ratos avaliando-se macroscopia, tensiometria e microscopia. MÉTODO: A amostra foi constituída por 32 ratos Wistar, divididos em dois grupos de 16 animais e quatro subgrupos de oito, submetidos à eutanásia com 15 dias e 30 dias para avaliação. As variáveis macroscópicas foram: presença de hematoma nos bordos da sutura da tela cirúrgica na parede abdominal, união entre a tela e a borda da ferida, presença de infecção no sítio cirúrgico, presença de fístulas de vísceras com a tela cirúrgica, presença de aderências dentro da cavidade abdominal e presença de hérnia incisional. Na microscopia avaliaram-se as fases do processo inflamatório da cicatrização, e na tensiometria a força tênsil necessária para ruptura do material. RESULTADOS: A união entre a tela cirúrgica e a borda da ferida foi melhor no subgrupo Ultrapro 15 dias que no Proceed 15 dias; com 30 dias foi igual nos dois subgrupos. Não houve diferença significativa quanto às demais variáveis da macroscopia. Os dois grupos nos dois momentos tiveram a mesma proporção de casos com processo inflamatório crônico, mas houve maior escore de inflamação do Ultrapro 15 dias que do Ultrapro 30 dias. O subgrupo Ultrapro 15 dias mostrou força de ruptura maior que o subgrupo Proceed 15 dias, mas em 30 dias não houve diferença. Ultrapro mostrou força de ruptura igual para os dois momentos, mas Proceed 30 dias mostrou força de ruptura maior que Proceed 15 dias. CONCLUSÃO: As telas são semelhantes nas variáveis analisadas.

-Background -The gastrorraphy isolated or associated with the use of biological adhesives formed throughout the history of surgery the usual way to promote healing in gastric lesions; however, the use of herbal medicine has been increasingly employed to help the wound healing. Aim -To evaluate the wound healing caused in the stomach of rats using extract of Schinus terebinthifolius Raddi and Carapa guianensis Aublet oil. Methods -Ninety rats, adult males were divided into three groups: aroeira, andiroba and control group, which were subdivided into three subgroups of five animals according to the time of the deaths (seven, 14 and 21 days). All underwent the same surgical procedure (injury and suture the stomach) differing only to the animals in groups aroeira and andiroba that received a daily dose of 100 mg / kg of hydroalcoholic extract and oil, by gavage, while the control group received normal saline. The parameters evaluated were the macroscopic and microscopic test of resistance to air insufflation and test the traction force.Results -All animals showed good healing of gastric and abdominal wall without infection and dehiscence. Both groups presented neighboring organs adhesions on the gastric surface. The endurance test for air insufflation showed higher average pressure within seven days and the test revealed greater traction force of rupture between seven and 14 days in groups aroeira and andiroba. The intensity of chronic inflammation revealed statistically significant differences in angiogenesis and fibroblast proliferation. Conclusion -The use of extract of Schinus terebinthifolius Raddi and Carapa guianensis Aublet oil favored the gastric wound healing in rats.RESUMO -Racional -A gastrorrafia isolada ou associada ao uso de adesivos biológicos constituiu ao longo da história da cirurgia a forma usual de promover a cicatrização nas lesões gástricas; entretanto, o uso de fitoterápico tem sido cada vez mais empregado para auxiliar o processo cicatrical. Objetivo -Avaliar a cicatrização de ferida provocada no estômago de ratos com uso do extrato hidroalcoólico de Schinus terebinthifolius Raddi e óleo da Carapa guianensis Aublet. Métodos -Foram utilizados 90 ratos, adultos, machos, distribuídos em três grupos: grupo aroeira, grupo controle e grupo andiroba, os quais foram subdivididos em três subgrupos de cinco animais conforme o momento da morte induzida (sete, 14 e 21 dias). Todos foram submetidos ao mesmo procedimento cirúrgico (lesão e rafia do estômago) diferindo apenas que os animais dos grupos aroeira e andiroba receberam dose diária de 100 mg/kg do extrato hidroalcoólico e do óleo, via gavagem, enquanto o grupo controle recebeu solução salina isotônica. Os parâmetros avaliados foram: alterações macroscópicas e microscópicas, teste de resistência à insuflação de ar atmosférico e teste pela força de tração. Resultados -Todos os animais demonstraram boa cicatrização da parede abdominal e das gastrorrafias, sem infecção e deiscência. Ambos os grupos apresentaram aderências à superfície das ga...

PURPOSE:To evaluate the healing process of a defect in the ventral abdominal wall of rats, comparing the polypropylene and polypropylene/poliglecaprone meshes on the 30 th and 60 th postoperative day. METHODS: Thirty two Wistar rats were submitted to a ventral abdominal wall defect, with integrity of the parietal peritoneum. In the repair, were used polypropylene (group A) and polypropylene/poliglecaprone (group B) meshes. The groups were subdivided into four subgroups of eight animals euthanized on the 30 th (A30 and B30) and 60 th postoperative day (A60 and B60). Fragments of the abdominal wall of the animals were submitted to macroscopic, tensiometric and histological evaluations. RESULTS:The tensiometry on subgroup A30 showed a mean average break point of 0.78 MPa and in A60, 0.66 Mpa. In subgroup B30 it was 0.84 MPa and in B60, 1.27 Mpa. The score of the inflammatory process showed subacute phase on A30 and B30 sub-groups and chronic inflammatory process in subgroups A30 and 60B. CONCLUSIONS: The tensile strength was higher on the wall repaired by polypropylene/poliglecaprone mesh in the 60 th post-operative day. Histology showed higher concentration of fibrosis on the surface of the polypropylene mesh with a tendency to encapsulation. In polypropylene/poliglecaprone subgroups the histology showed higher concentration of fibrosis on the surface of mesh filaments. Key words: Surgical Mesh. Hernia, Abdominal. Polypropylenes. Rats. RESUMO OBJETIVO: Avaliar a cicatrização de um defeito, na parede abdominal ventral de ratos, comparando-se as telas de polipropileno e polipropileno/poliglecaprone no 30º e 60º dia do pós-operatório. MÉTODOS: Trinta e dois ratos Wistar foram submetidos à produção de defeito na parede abdominal ventral, com integridade do peritônio parietal. Na correção foram utilizadas as telas de polipropileno (grupo A) e polipropileno/poliglecaprone (grupo B). Houve subdivisão em quatro subgrupos (A30, A60, B30 e B60) de oito animais que foram submetidos à eutanásia no 30º e 60º dia do pós-operatório. Fragmentos da parede abdominal foram submetidos à análise macroscópica, tensiométrica e histológica. RESULTADOS: A tensiometria no subgrupo A30 mostrou tensão média de ruptura de 0,78 Mpa e no subgrupo A60 de 0,66 MPa. No subgrupo B30 foi de 0,84 MPa e no B60 de 1,27 MPa. O escore do processo inflamatório mostrou fase subaguda nos subgrupos A30 e B30 e processo inflamatório crônico no subgrupo A60 e B60. CONCLUSÕES: A resistência à tensão foi maior na parede reparada pela tela de polipropileno/poliglecaprone no 60° dia pós-operatório. Na análise histológica houve maior concentração da fibrose na superfície da tela de polipropileno com tendência ao encapsulamento. Nos subgrupos polipropileno/poliglecaprone a análise histológica mostrou maior fibrose entre os filamentos da tela. Descritores: Telas Cirúrgicas. Hérnia Abdominal. Polipropilenos. Ratos.Comparative study between polypropylene and polypropylene/poliglecaprone meshes used in the correction of abdominal wall defect in rats

INTRODUÇÃO: O uso de telas para a correção cirúrgica de defeito herniários da parede abdominal contribuiu para a acentuada redução dos índices de recidiva das hérnias. Contudo, o seu uso intra-abdominal cursa com a formação de aderências e diversas complicações, dentre elas a obstrução intestinal. MÉTODO: Foram selecionados, nos bancos de dados PubMed e Medline, 27 artigos científicos atualizados e com informações relevantes à respeito das propriedades mais importantes das telas (material, diâmetro dos poros, estrutura tridimensional e peso molecular) para colocação intra-abdominal, evitando-se a formação de aderências e recidiva da hérnia. CONCLUSÃO: Atualmente as telas de dupla-composição são as mais indicadas para uso intra-peritoneal. Estas têm uma face composta por um material (preferencialmente macro poroso e reticular) que fica em contato com a musculatura e tem o objetivo de manter a resistência tênsil da parede abdominal. A outra face, composta por outro tipo de material (preferencialmente micro poroso e laminar), deve ficar em contato com os órgãos intra-abdominais, porém sem induzir a formação de aderências

Background:Bariatric operations have variable range of complications and postoperative benefits. Gastroesophageal reflux is considered potential factor that may result in damage to the esophageal mucosa and this subject is quite controversial in the literature. Aim : To evaluate patients who underwent to Roux-en-Y gastrojejunal bypass correlating epidemiologic and endoscopic findings in pre and postoperative periods. Method : A retrospective, paired study which evaluated 110 patients. Inclusion criteria were formal indication for bariatric surgery and patients with pre and postoperative endoscopy. Exclusion criteria were previous bariatric surgery, patients subjected to other types of bariatric surgery and those who had no pre or postoperative upper digestive endoscopy. The epidemiological variables were: sex, age, body mass index, type 2 diabetes mellitus or impaired glucose tolerance, and preoperative dyslipidemia. Results : The preoperative upper endoscopy was normal in 26.4% of the patients. Among endoscopic alterations, the hiatus hernia was the most prevalent followed by non-erosive gastritis. The postoperative upper endoscopy was normal in 40.9% and stenosis was the most prevalent followed by marginal ulcer. Correlation on pre and postoperative endoscopies, was found 100% reduction of hiatal hernias and 88% of esophagitis. There was no statistical significance in relationship to anastomotic stenosis with preoperative other variables. Conclusions:There was significant decrease in postoperative hiatus hernia, erosive esophagitis, non-erosive esophagitis, erosive gastritis and non-erosive gastritis with the operation. Stenosis of the gastrojejunostomy anastomosis was the most prevalent postoperative complication with no correlation with preoperative variables.

BackgroundThe association between obesity and gastroesophageal reflux disease has a high incidence and may be present in half of obese patients with surgical indication. Bariatric operations can also induce reflux alone - differently from BMI factors - and its mechanisms are dependent on the type of procedure performed.ObjectiveTo perform a literature review comparing the two procedures currently most used for surgical treatment of obesity and analyze their relationship with the advent of pre-existing reflux disease or its appearance only in postoperative period.MethodThe literature was reviewed in virtual database Medline/PubMed, SciELO, Lilacs, Embase and Cochrane crossing the following MeSH descriptors: gastric bypass AND / OR anastomosis, Roux-en-Y AND / OR gastroesophageal reflux AND / OR gastroenterostomy AND / OR gastrectomy AND / OR obesity AND / OR bariatric surgery AND / OR postoperative period. A total of 135 relevant references were considered but only 30 were used in this article. Also was added the experience of the authors of this article in handling these techniques on this field.ConclusionThe structural changes caused by surgical technique in vertical gastrectomy shows greater commitment of antireflux mechanisms predisposing the induction of GERD postoperatively compared to the surgical technique performed in the gastrointestinal Bypass Roux-en-Y.

Background: Helicobacter pylori has been extensively studied since 1982 it is estimated that 50% of the world population is affected. The literature lacks studies that show the change of its prevalence in the same population over time. Aim: To compare the prevalence of H. pylori in 10 years interval in a population that was submitted to upper endoscopy in the same endoscopy service. Method: Observational, retrospective and cross-sectional study comparing the prevalence of H. pylori in two samples with 10 years apart (2004 and 2014) who underwent endoscopy with biopsy and urease. Patients were studied in three consecutive months of 2004, compared to three consecutive months of 2014. The total number of patients was 2536, and 1406 in 2004 and 1130 in 2014. Results: There were positive for H. pylori in 17 % of the sample as a whole. There was a significant decrease in the prevalence from 19.3% in 2004 to 14.1% in 2014 (p<0.005). Conclusion: There was a 5.2% reduction in the prevalence of H. pylori comparing two periods of three consecutive months with 10 years apart in two equivalent population samples.

PURPOSE: To study the intraperitoneal use of polyester with collagen and polytetrafluoroethylene meshes in the correction of total ventral wall defects in rats. METHODS: Thirty two rats were evaluated and divided randomly into four groups and underwent laparotomy and preparation of total defects of the abdominal wall. Next, the correction of the defect with the intraperitoneal placement of the chosen mesh was performed. The rats were submitted to euthanasia at 30 and 90 days after surgery. Were analyzed the macroscopic adhesions and microscopic aspects, and applied stress rupture test RESULTS: All animals showed intraperitoneal adhesions in varying degrees, with no statistical significance difference. There was no difference also between groups in the evaluation of stress rupture tests. On the microscopic aspect, the A30 group had less inflammatory reaction and less formation of granulomas and foreign body reaction that the B30 group, with significant difference. CONCLUSIONS: There was no difference in intraperitoneal adhesion and tensile rupture strength among groups. Group B30 presented granulomatous inflammatory reaction at the site of mesh attachment to the wall significantly higher than the A30.