Congenital extrahepatic portosystemic deviation of gastric vein with azygos in a bitch

Background: Portosystemic shunt (PSS), an alteration commonly found in toy dogs, is caused by an anastomosis between the systemic and portal circulation, interfering with the metabolism of several toxins. It can be of congenital or acquired origin and is classified as intra- or extrahepatic. Clinical signs include the gastrointestinal tract, nervous system, and urinary system according to the fraction of the shunt. It is diagnosed by several imaging tests and exploratory laparotomy. Therapy involves drug therapy and/or surgical correction of the anomalous vessels. Thus, the aim is to present an unusual case of extrahepatic cPSS originating from the left gastric vein and insertion into the azygos vein. Case: A 2-year-old female toy poodle, spayed, weighing 2.7 kg was treated with a history of recurrent cystitis and neurological signs such as focal seizures, ataxia, tremors, blindness, lethargy, head pressing, and compulsive gait. Complementary tests revealed normochromic microcytic anemia, neutrophilia-induced leukocytosis, monocytosis, and lymphopenia. Biochemical analysis revealed hypoproteinemia due to hypoglobulinemia, an increase in alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase, and a decrease in urea. In the urinalysis, ammonium biurate crystals were detected, and Doppler ultrasound revealed microhepathy and the presence of an anomalous gastrosplenic vein inserted into the azygos vein, a finding compatible with the congenital extrahepatic PSS. Abdominal tomography confirmed vascular deviation with a sinuous path originating from the left gastric and splenic veins, inserting into the azygos vein, measuring approximately 5.95 cm in length. Cranial tomography revealed changes consistent with hepatic encephalopathy. Drug therapy was performed with hydration, liver chow, lactulose, probiotics, metronidazole, S-adenosyl-L-methionine, and ursodeoxycholic acid, and after 15 days, surgery was performed to place a 3.5 mm ameroid constrictor ring for gradual occlusion of the anomalous vessel. The animal recovered well, and a control abdominal ultrasound was repeated 30 days after the procedure, noting that the constrictor had not yet fully occluded the deviation. Doppler imaging revealed a favorable evolution with an increase in the diameter of the portal vein in the hepatopetal direction. The patient was followed-up for a year and had a normal and healthy life. Discussion: Extrahepatic PSS is frequently diagnosed in purebred and toy dogs, commonly occurring between the portal vein and one of its tributaries, with a lower frequency of anomalous vessels between the azygos veins, as in the present report. The patient's age and clinical signs were compatible with the disease, in addition to ammonia biurate crystals and hematological and biochemical alterations. The neurological clinical signs observed were compatible with hepatic encephalopathy secondary to congenital PSS. The imaging examinations facilitated the identification of the extrahepatic vascular anomaly, with the tomography being more accurate and helping in proper surgical planning. Clinical treatment should be performed for presurgical stabilization, and occlusion can be performed by placing cellophane bands or an ameroid constrictor, which is the technique of choice for congenital PSS, as it allows for slow constriction to avoid acute portal hypertension, as in this case, emphasizing that anesthesia in animals with portosystemic shunts must be performed with care.

Microsurgical arterial anastomosis in young and adult rats: an evolutive and comparative study

Purpose: To evaluate the caliber of an arterial micro-anastomosis in the young growing animal using a continuous suture technique. Additionally, late morphological changes and blood flows distal to the anastomosis were evaluated. Methods: Seventy-four Wistar rats were submitted to laparotomy to access the aorta for blood flow measurement. The aorta was sectioned using microsurgery technique and an end-to-end anastomosis with continuous suture. After a period of six months to one year, the anastomosis was checked. Results: Regarding the size of the aortas, comparing the pre- and postoperative values, there was an increase of 13.33% in adult animals and 25% in young animals, without any difference in the blood flows. Conclusions: The arteries of young rats show signs of growth at the site of the anastomosis performed with continuous suture.

Prolapso uretral em um cão da raça American Bully / Urethral prolapse in a dog of the American Bully breed

O prolapso uretral, o qual é incomum em cães, se caracteriza pela protusão da mucosa uretral além da extremidade do pênis e do orifício externo da uretra. Pode ocorrer por causas congênitas ou adquiridas, tendo maior incidência em animais jovens não castrados. O objetivo do presente trabalho é relatar um caso de prolapso uretral em um cão não castrado da raça American Bully Terrier, de dois anos, o qual foi atendido na Universidade Estácio de Sá localizada no Rio de Janeiro com histórico de lambedura excessiva do pênis, disúria, sangramento prepucial e protrusão da mucosa uretral após tentativa de cópula. Durante a avaliação física o animal apresentou todos os parâmetros clínicos dentro da normalidade, entretanto demonstrava agitação excessiva e dor na região afetada. Então, o diagnóstico foi definido por meio da inspeção direta da visualização da mucosa uretral protusa. Frente ao quadro clínico e físico do animal, foi adotado o procedimento cirúrgico de ressecção e anastomose da porção uretral prolapsada. Desta forma, conclui-se que esta técnica cirúrgica se mostrou eficaz, visto que o referido paciente apresentou ótima recuperação e cicatrização uretral, sem quaisquer sinais de complicações pós-cirúrgicas.

Urethral prolapse, which is uncommon in dogs, is characterized by protrusion of the urethral mucosa beyond the tip of the penis and the external orifice of the urethra. It can occur due to congenital or acquired causes, with a higher incidence in young animals not castrated. The present study aims to report a case of urethral prolapse in a non-castrated dog of 2 years old (American Bully Terrier), which was treated at the Estácio de Sá University located in Rio de Janeiro city, with a history of excessive penis licking, dysuria, prepucial bleeding, and protrusion of the urethral mucosa after an attempt of copulation. During the physical evaluation, the animal presented all clinical parameters within the normal range; however, it showed excessive agitation and pain in the affected region. Then, the diagnosis was defined through direct inspection of the visualization of the protruding urethral mucosa. Given the animal's clinical and physical condition, the surgical procedure of resection and anastomosis of the prolapsed urethral portion was adopted. Therefore, it is concluded that this surgical technique proved to be effective since the patient presented excellent recovery and urethral healing, without any signs of post-surgical complications.

Effects of different gastrointestinal reconstruction techniques on nutrition, anemia, and quality of life in laparoscopic distal gastrectomy for gastric cancer

Purpose: To explore the effect of different gastrointestinal reconstruction techniques on laparoscopic distal gastrectomy of gastric cancer on the nutritional and anemia status, and quality of life (QoL) of patients. Methods: Eligible patients were randomly divided into three groups (n=36/group): Billroth I anastomosis group, Billroth II combined with Braun anastomosis group, and Roux-en-Y anastomosis group. Related indicators were compared and analyzed. Results: The general data were comparable among the three groups (all P>0.05). Among the surgical-related indicators and postoperative recovery indicators, only the comparison of the operation time was statistically significant (P=0.004). The follow-up time was 5~36 months (average 27.9 months). In terms of nutritional and anemia indicators, only the differences in the levels of prealbumin, hemoglobin and serum ferritin in 24 months after operation showed significant differences (P=0.015, P=0.003, P=0.005, respectively). There were no significant differences in hospital readmission rate, overall survival, and QoL among the three groups (all P>0.05). Conclusions: In laparoscopic gastrectomy for stage II~III distal gastric cancer, Billroth I anastomosis has shorter operation time than Billroth II combined with Braun anastomosis and Roux-en-Y anastomosis and advantages in the improvement of nutritional status and anemia recovery.

Carcinoma uretral primário em uma cadela - tratamento multimodal / Primary urethral carcinoma in a bitch - multimodal treatment

Background: Urethral tumors are uncommon in canines, represented predominantly by transitional cell carcinoma, marked by aggressive behavior associated with short life expectancy. Definitive diagnosis is achieved by histopathological analysis. Surgery associated with chemotherapy is the main therapeutic alternative. The aim of this paper is to report a case of primary transitional cell carcinoma of the urethra in a bitch, submitted to surgical treatment associated with conventional adjuvant chemotherapy and metronomic chemotherapy, achieving survival of 21 months, to date. Case: A 12-year-old bitch mixed breed was admitted at the Veterinary Hospital of Federal Rural University of Rio de Janeiro (UFRRJ), manifesting hematuria and urinary incontinence for one month. Physical examination indicated that vital parameters were within normal limits. Laboratory tests of blood count and serum biochemistry, urinalysis, culture, urinary antibiogram, and abdominal ultrasound were performed. The ultrasound image suggested a neoplastic urethral process. Because of the suspicion of neoplasm, a thoracic X-ray was performed, showing no evidence of metastasis. Computed tomography (CT) of the abdominal region was performed, revealing an expansive lesion in the urethra with loss of definition of the walls and urethral lumen extending to the level of the pelvic floor, measuring about 2.9 x 1.4 x 1.2 cm. After preanesthetic exams, the animal underwent resection and surgical anastomosis of the affected urethral region. The sectioned tissue was sent for histopathological analysis, with diagnosis of transitional cell carcinoma. Adjuvant chemotherapy was performed using carboplatin at a dose of 250 mg/m², intravenously, every 21 days for 6 sessions. After completing the protocol, abdominal ultrasonography was performed again, which showed a cicatricial process in the urethral region of the surgical excision, with no sign of tumor recurrence. A metronomic chemotherapy protocol was then started with cyclophosphamide at a dose of 15 mg/m², daily for 6 months, with periodic oncological follow-up. At the end of the period, the animal remained under periodic follow-up with ultrasound exams performed at 2-month intervals, and has been free from recurrence for 21 months until now. Discussion: Urethral neoplasms account for 0.5 - 2% of all canine tumors, and are represented mostly by transitional cell carcinomas. Clinical signs of urinary obstruction and hematuria are the most common, as reported in the patient in question. The definitive diagnosis is by histopathological examination. However, imaging tests such as computed tomography are important in the initial investigation and surgical planning. The indicated treatment is surgical resection of the mass with subsequent adjuvant chemotherapy or radiotherapy. The chemotherapy protocol associating cisplatin and piroxicam can achieve remission rates of 70%, but this association has a high nephrotoxic effect. In the present case, cisplatin was replaced by carboplatin in order to reduce the nephrotoxic effects of chemotherapy. The metronomic protocol using cyclophosphamide was used as maintenance therapy, at the end of the conventional chemotherapy protocol. Survival achieved was longer than that described in the literature in cases of transitional cell carcinomas in the urethral region. Therefore, multimodal therapy using surgery associated with conventional and metronomic chemotherapy, is an option in canines with urethral carcinoma.

Techniques of orthotopic renal transplantation in pigs: one donor to two recipients via inverted grafting

Purpose Although transplanting two kidneys from a single donor to two recipients has some advantages, the right and left kidneys are not anatomically identical; thus, a surgical procedure considering the anatomical features of the donor kidneys is needed when transplanting them into the opposite renal fossae. Based on vast experience, the surgical details of pig orthotopic kidney transplantation from one donor to two recipients was reported. Methods When the right kidney was transplanted to the left renal fossa, the graft was inverted upside down, not backwards, thus ensuring that the anteroposterior relationship of the renal vessels was maintained and anatomically natural vascular anastomosis could be performed. Results Using this technique, we could have developed a pig experimental model that is safe and has a high success rate, even for researchers in the middle of their training. This technique of inverting the graft upside down was reported in human kidney transplantation to make vascular anastomosis easier. Conclusions In pig orthotopic kidney transplantation from one donor to two recipients, an anatomically natural vascular anastomosis could be performed via inverted grafting when the right kidney was transplanted into the left renal fossa.(AU)

Submerged vascular anastomosis. A technique for vascular suturing in experimental microsurgery

ABSTRACT Purpose: To evaluate the impact of submersion of the microsurgical anastomosis suture area using saline (0.9% NaCl) in an experimental laboratory during the training of medical students and resident physicians. Methods: Wistar rats (n = 10) were selected to have the two femoral arteries sectioned and anastomosed end-to-end under optical magnification. They were randomly divided, so that on one side suturing was performed under submersion with saline, and the contralateral side was kept dry during the procedure. The surgical times, as well as the patency within 30 min and 72 h of the procedure, were evaluated. Results: Six male Wistar rats survived the surgical anesthetic procedure, with the average initial weight of 243.3 g and the average artery diameter of 0.86 mm, with average time of 15.67 min for the submerged technique and 20.50 min for the dry technique (p = 0.03). The failure rates were 17 and 50% for the submerged group and the dry one, respectively (p = 0.62). Conclusions: Submerged microvascular suture does not compromise the patency of the vessel or increase the time of anastomosis. Therefore, it is a strategy that can be applied by the surgeon according to his/her technical preferences.

Intussuscepção intestinal associada à protrusão cloacal em Trachemys scripta elegans / Intestinal intussusception associated with cloacal protusion in Trachemys scripta elegans

Background: Gastrointestinal dysfunction in reptiles is a common condition seen in animal medicine, and is often causedby inappropriate husbandry. The purpose of this report is to describe the case of a surgical procedure for enterectomy ofthe small intestines, performed as treatment for an intussusception with cloacal protrusion that occurred in a red-earedslider (Trachemys scripta elegans) kept as a pet.Case: A 20-year-old red-eared slider (Trachemys scripta elegans) was taken into medical care after the owner’s observationof a cloacal protrusion that had started 72 h previously. During physical examination the protrusion was noted as an intestinalsegment of approximately 5 cm, which was not reducible. Complementary examinations, including radiography and hematological profiling, were performed and revealed no significant findings; therefore, it was decided that an exploratory celiotomywould be conducted. The patient was referred to the surgical unit for the procedure and underwent surgical anesthesia. Afterappropriate antisepsis of the surgical area, a plastron osteotomy was performed using a previously sterilized oscillatory saw ata 45º angulation. The celomatic membrane was subsequently incised to enable both cavity and intestinal inspection allowingobservation of the intussusception in the small intestine of the animal with the intussuscept segment protruding through thecloaca. The intussusception was undone, and an enterectomy was performed to remove the unviable intestine, using intestinalresection and subsequent anastomosis with simple interrupted sutures using 4-0 nylon, followed by intestinal reposition in thecavity. The celomatic membrane was closed using continuous suture with 4-0 nylon. The plastron fragment was then repositioned with the aid of eight...

Intussuscepção intestinal associada à protrusão cloacal em Trachemys scripta elegans / Intestinal intussusception associated with cloacal protusion in Trachemys scripta elegans

Background: Gastrointestinal dysfunction in reptiles is a common condition seen in animal medicine, and is often causedby inappropriate husbandry. The purpose of this report is to describe the case of a surgical procedure for enterectomy ofthe small intestines, performed as treatment for an intussusception with cloacal protrusion that occurred in a red-earedslider (Trachemys scripta elegans) kept as a pet.Case: A 20-year-old red-eared slider (Trachemys scripta elegans) was taken into medical care after the owners observationof a cloacal protrusion that had started 72 h previously. During physical examination the protrusion was noted as an intestinalsegment of approximately 5 cm, which was not reducible. Complementary examinations, including radiography and hematological profiling, were performed and revealed no significant findings; therefore, it was decided that an exploratory celiotomywould be conducted. The patient was referred to the surgical unit for the procedure and underwent surgical anesthesia. Afterappropriate antisepsis of the surgical area, a plastron osteotomy was performed using a previously sterilized oscillatory saw ata 45º angulation. The celomatic membrane was subsequently incised to enable both cavity and intestinal inspection allowingobservation of the intussusception in the small intestine of the animal with the intussuscept segment protruding through thecloaca. The intussusception was undone, and an enterectomy was performed to remove the unviable intestine, using intestinalresection and subsequent anastomosis with simple interrupted sutures using 4-0 nylon, followed by intestinal reposition in thecavity. The celomatic membrane was closed using continuous suture with 4-0 nylon. The plastron fragment was then repositioned with the aid of eight...(AU)

Simulated training model of ureteropyelic anastomosis in laparoscopic pyeloplasty

Purpose: To develop a model for simulated training of ureteropyelic anastomosis in laparoscopicpyeloplasty. Methods: Longitudinal and experimental study, with 16 participants. A synthetic instrument was produced to simulate the renal pelvis and the proximal portion of the ureter positioned on a platform within laparoscopic simulators, thereby resulting in the realistic simulation of the ureteropelvic anastomosis. A step-by-step guide was also developed for the accomplishment of the ureteropelvic anastomosis training model. Results: In the evaluation of all participants suture training, a decrease was found in the time needed to perform the anastomosis, with a median of 17.83 min in the 1st step and 14.21 min in the last one (p = 0.01). Regarding the knots, in the 1st step, 5% of them were considered firm, with an evolution to 30% in the last step (p = 0.011). Conclusion: We noticed improvement in the ability to perform the ureteropelvic anastomosis by participants with no experience with it. Therefore, even unexperienced participants can improve their skills with this training. Moreover, we observed the effectiveness of the model use, confirmed by the participants opinion and its validation by expert surgeons.(AU)

Quercetin associated with dimethylsulfoxide has a curative effect on experimental colon anastomosis injury

Purpose. To examine the effects of quercetin on healing of experimental colon anastomosis injury in early and late period.. Methods. Eighty male Wistar-Albino rats were divided into 8 groups. For all groups, left colons of the rats were resected and for the rest end-to-end anastomosis was performed. Two of the groups for which the experiment protocol was ended on the 3rd and 7th day following the anastomosis were not administered with either quercetin or dimethylsulfoxide DMSO, whereas two other groups were administered with DMSO only, and four other groups were administered with quercetin dissolved in DMSO in doses of 20 and 100 mg/kg during the protocol. At the end of the study, anastomosis line was resected, histopathological evaluation was performed and bursting pressure, malondialdehyde, superoxide dismutase, catalase, and hydroxyproline levels were measured.. Results. Quercetin significantly increased hydroxyproline, superoxide dismutase, catalase levels, histopathological healing score, bursting pressure values and decreased malondialdehyde level in early period. It also significantly increased superoxide dismutase, catalase, and hydroxyproline levels and decreased malondialdehyde level in late period. Conclusion: It was seen that quercetin speeds up the injury healing process and reveals an antioxidant effect, specifically in early period.(AU)

Behavior of free omental grafts without vascular anastomosis implanted in cats experimental wounds / Comportamento do enxerto omental livre sem anastomose vascular implantado em feridas experimentais de gatos

It is known that skin healing in cats is slower and has a higher complication rate than in dogs, what leads to search for new resources to enhance this process. Omentum properties in the aid of tissue repair are known and, among the forms of extraperitoneal omentalization, the use of free omental grafts without vascular anastomosis is advantageous, but little studied; there is no knowledge about its effect on skin healing, nor if its still viable when implanted in the subcutaneous space. Thus, the present study aimed to describe possible alterations produced by free omental graft without anastomosis inserted in the subcutaneous space, by means of macroscopic clinical analysis of the implantation region in cats. Twenty intact female cats were divided into two groups (Group 1: treated animals; Group 2: controls) of similar size. All animals were subjected to ovariosalpingohysterectomy (OSH) prior to the induction of an experimental wound for the implantation of the omental graft. Wounds were evaluated on days 1, 2, 4, 8, and 15 postsurgery and then weekly until no lesions were noted. Data regarding color, consistency, presence or absence of crusts, wound resistance, and volume measurements were recorded. There was activation of the omentum on the 4th day of evaluation with reduction of hemorrhage and an increase in the resistance to traction of the experimental wound. We concluded that the omentum without vascular anastomosis is capable of maintaining its viability and exert positive influence on the repair process without showing deleterious signs on the implantation site.(AU)

Sabe-se que a cicatrização de pele em gatos é mais lenta e apresenta índice maior de complicações que nos cães, dai a importância da busca de novos recursos para estimular o processo cicatricial. São conhecidas as propriedades do omento no auxílio ao reparo tecidual e, dentre as formas de omentalização extraperitoneal, o uso do omento livre sem anastomose vascular é vantajoso, porém pouco estudado; não há conhecimento sobre seu efeito na cicatrização cutânea, tampouco se permanece viável quando implantado no espaço subcutâneo. Sendo assim, o presente trabalho tem como objetivo avaliar possíveis alterações produzidas pelo enxerto omental livre sem anastomose inserido no espaço subcutâneo, por meio da avaliação clínica macroscópica da região de implantação em gatos. Foram utilizadas 20 gatas, de idade entre um e sete anos, sem alterações em exame de sangue, FIV/FELV negativas. Os animais foram divididos em dois grupos (Tratado e Controle) de igual tamanho, diferindo quanto à utilização do enxerto de omento livre. Foi realizada cirurgia de ovariossalpingohisterectomia (OSH) em todos os animais, previamente à criação da ferida experimental para implantação ou não do enxerto omental. As feridas foram avaliadas nos dias 1, 2, 4, 8 e 15 do pós-operatório e a partir de então semanalmente, até nenhuma alteração ser observada. Foram anotados dados referentes à coloração, consistência, presença de crosta, resistência da ferida e medidas do volume. Nos resultados destacou-se a ativação do omento no quarto dia de avaliação, observada pelo aumento de volume, com redução de hemorragia e aumento na resistência da ferida experimental à tração. Conclui-se que o omento em sua forma livre sem anastomose é capaz de manter sua viabilidade e exercer influência positiva sobre o processo de reparo, sem demonstrar sinais deletérios sobre a região implantada.(AU)

The influence of platelet-rich plasma (PRP) on colonic anastomosis healing impaired by intraperitoneal 5-flourouracil application: an experimental study

Purpose 5-flourourasil (5-FU) is commonly used for early intraperitoneal chemotherapy in colorectal or appendiceal cancer patients with peritoneal carcinomatosis. Due to its effect, anastomosis healing can be impaired and leads to anastomotic leakage. In this study, we aimed to investigate the potential healing effect of platelet-rich plasma (PRP) on colonic anastomosis impaired by intraperitoneal 5-flourouracil application. Methods After ten rats were sacrificed for preparing PRP, forty Wistar-albino rats were subjected to colonic anastomosis, and randomly allocated into four groups including 10 rats each. According to receiving PRP and/or 5-FU application, the groups were formed as control (C), 5-FU without PRP (CT), anastomosis with PRP (C-PRP), and 5-FU with PRP (CT-PRP). CT and CT-PRP groups also received 5-FU intraperitoneally on postoperative day 1 (POD 1). All animals were euthanized on pod 7. The body weight change, anastomotic bursting pressure (ABP), tissue hydroxiprolin (TH) and histopathological examination of each group were analyzed. Results 5-FU application significantly reduced ABP levels when compared with group C, C-PRP and CT-PRP (for each comparison, p 0,01). PRP application in CT-PRP group raised the measure of ABP up to the levels of C group. Although tissue hydroxyproline levels (THL) levels of CT-PRP group were found higher than CT group, it was not significant (p=0.112). Microscopically, comparing with CT group, PRP application significantly promoted the healing of colonic anastomosis subjected to 5-FU application by improving tissue edema, necrosis, submucosal bridging and collagen formation (p 0.05). Tissue healing in CT-PRP group was observed as good as the control groups. (C, C-PRP, p=0.181, p=0.134; respectively). Conclusion PRP administration on colonic anastomosis significantly promotes the healing process of anastomosis in rats receiving 5-FU. This result encourages further clinical use of PRP to reduce the frequency of AL in patients receiving EPIC.(AU)

Effect of preconditioning and postoperative hyperbaric oxygen therapy on colonic anastomosis healing with and without ischemia in rats

Purpose To investigate the effect of hyperbaric oxygen therapy on colonic anastomosis healing with and without ischemia in rats. Methods Forty female rats underwent segmental resection of 1 cm of the left colon followed by end-to-end anastomosis. They were randomly assigned to four groups (n=10 each), a sham group; two groups were submitted to Hyperbaric Oxygen therapy (HBOT) with and without induced ischemia and the induced ischemia group without HBOT. The HBOT protocol evaluated was 100% O2 at 2.4 Atmosphere absolute pressure (ATA) for 60 minutes, two sessions before as a preconditioning protocol and three sessions after the operation. Clinical course and mortality were monitored during all experiment and on the day of euthanasia on the fourth day after laparotomy. Macroscopic appearance of the abdominal cavity were assessed and samples for breaking strength of the anastomosis and histopathological parameters were collected. Results There was no statistically significant difference in mortality or anastomosis leak between the four experimental groups. Anastomosis breaking strength was similar across groups. Conclusion The HBOT protocol tested herein at 2.4 ATA did not affect histopathological and biomechanical parameters of colonic anastomotic healing, neither the clinical outcomes death and anastomosis leak on the fourth day after laparotomy.(AU)

Quercetin associated with dimethylsulfoxide has a curative effect on experimental colon anastomosis injury

Purpose To examine the effects of quercetin on healing of experimental colon anastomosis injury in early and late period. Methods Eighty male Wistar-Albino rats were divided into 8 groups. For all groups, left colons of the rats were resected and for the rest end-to-end anastomosis was performed. Two of the groups for which the experiment protocol was ended on the 3rd and 7th day following the anastomosis were not administered with either quercetin or dimethylsulfoxide DMSO, whereas two other groups were administered with DMSO only, and four other groups were administered with quercetin dissolved in DMSO in doses of 20 and 100 mg/kg during the protocol. At the end of the study, anastomosis line was resected, histopathological evaluation was performed and bursting pressure, malondialdehyde, superoxide dismutase, catalase, and hydroxyproline levels were measured. Results Quercetin significantly increased hydroxyproline, superoxide dismutase, catalase levels, histopathological healing score, bursting pressure values and decreased malondialdehyde level in early period. It also significantly increased superoxide dismutase, catalase, and hydroxyproline levels and decreased malondialdehyde level in late period. Conclusion It was seen that quercetin speeds up the injury healing process and reveals an antioxidant effect, specifically in early period.(AU)

Safety and effectiveness of laparoscopic Y-en-Roux gastric bypass surgery in obese elderly patients

Purpose. To analyze, in aged obese patients, the weight loss, comorbidity control, and safety postoperative complications of bariatric surgery by Roux-en-Y gastric bypass technique.. Methods. Twenty-seven patients who underwent laparoscopic weight-reducing gastroplasty with Roux-en-Y gastric bypass to treat obesity were included. All patients were ≥ 60 years old at the time of surgery. The Wilcoxon test was used for statistical analysis, and a p-value ≤0.05it was considered significant.. Results. Ten (90.9%) patients with dyslipidemia were cured (p < 0.001). Nine (81.8%) patients with type 2 diabetes mellitus had total improvement and 2 (18.2%) had partial improvement (p = 0.003). In 23 patients with systemic arterial hypertension, 9 (39.1%) achieved total improvement and 14 (60.9%) partial improvement (p = 0.140). Five (71.4%) patients with obstructive sleep apnea syndrome were cured (p = <0.001). For other comorbidities, no partial improvement or cure was shown.. Conclusions. Roux-en-Y gastric bypass surgery in obese elderly patients can be performed safely and with low morbidity and mortality rates. The benefits of weight loss and reduced comorbidities are promising and like those of the younger population.(AU)

Safety and effectiveness of laparoscopic Y-en-Roux gastric bypass surgery in obese elderly patients

Purpose To analyze, in aged obese patients, the weight loss, comorbidity control, and safety postoperative complications of bariatric surgery by Roux-en-Y gastric bypass technique. Methods Twenty-seven patients who underwent laparoscopic weight-reducing gastroplasty with Roux-en-Y gastric bypass to treat obesity were included. All patients were 60 years old at the time of surgery. The Wilcoxon test was used for statistical analysis, and a p-value 0.05it was considered significant. Results Ten (90.9%) patients with dyslipidemia were cured (p 0.001). Nine (81.8%) patients with type 2 diabetes mellitus had total improvement and 2 (18.2%) had partial improvement (p = 0.003). In 23 patients with systemic arterial hypertension, 9 (39.1%) achieved total improvement and 14 (60.9%) partial improvement (p = 0.140). Five (71.4%) patients with obstructive sleep apnea syndrome were cured (p = 0.001). For other comorbidities, no partial improvement or cure was shown. Conclusions Roux-en-Y gastric bypass surgery in obese elderly patients can be performed safely and with low morbidity and mortality rates. The benefits of weight loss and reduced comorbidities are promising and like those of the younger population.(AU)

Billroth I technique application after resection of gastric leiomyoma in a dog

Background: Gastric neoplasia is rare, corresponding to less than 1% of cases, with a lower prevalence of those involving smooth muscle tissues. In these cases, clinical signs worsen in the occurrence of pyloric obstruction, leading to clinical manifestations such as chronic emesis. The exeresis of the neoplasm is promoted as a therapeutic measure to reestablish gastrointestinal flow. There partial gastrectomy followed by gastroduodenal anastomosis, using the Billroth I technique, is among the available surgical techniques. The therapeutic success of the Billroth I technique after pylorectomy was reported in a dog with gastric leiomyoma. Case: A 9-year-old male Poodle dog, weighing 9.5 kg, was referred for clinical evaluation with a history of chronic vomiting starting three months ago, progressive weight loss, and melena, previously treated by another Veterinarian as idiopathic gastroenteritis. The physical evaluation of the animal showed a state of normal consciousness, body score 4/9, pale ocular and oral mucous membranes, respiratory rate 20 mpm, heart rate 166 bpm, a rectal temperature of 37.9°C, and dehydration degree of 8.0%. Blood count showed normocytic normochromic anemia and leukocytosis with shift to the right. Radiographic and endoscopic examinations were not noteworthy. Endoscopic biopsy after a histopathological evaluation showed no cellular or tissue atypia. On the other hand, abdominal ultrasound assessment revealed thickening with loss of echotexture and definition of the muscular layer of the gastric wall, pyloric and duodenum region compatible with benign antral muscle hypertrophy and/or pyloric neoplasia. The animal worsened 5 days after the initial treatment, with progressive episodes of emesis and melena, opting for an exploratory laparotomy. A mass of firm consistency measuring approximately 2.5 × 6.0 cm in diameter was found in the pyloric region, opting for a pylorectomy. The excised fragment was sent for histopathological...

Billroth I technique application after resection of gastric leiomyoma in a dog

Background: Gastric neoplasia is rare, corresponding to less than 1% of cases, with a lower prevalence of those involving smooth muscle tissues. In these cases, clinical signs worsen in the occurrence of pyloric obstruction, leading to clinical manifestations such as chronic emesis. The exeresis of the neoplasm is promoted as a therapeutic measure to reestablish gastrointestinal flow. There partial gastrectomy followed by gastroduodenal anastomosis, using the Billroth I technique, is among the available surgical techniques. The therapeutic success of the Billroth I technique after pylorectomy was reported in a dog with gastric leiomyoma. Case: A 9-year-old male Poodle dog, weighing 9.5 kg, was referred for clinical evaluation with a history of chronic vomiting starting three months ago, progressive weight loss, and melena, previously treated by another Veterinarian as idiopathic gastroenteritis. The physical evaluation of the animal showed a state of normal consciousness, body score 4/9, pale ocular and oral mucous membranes, respiratory rate 20 mpm, heart rate 166 bpm, a rectal temperature of 37.9°C, and dehydration degree of 8.0%. Blood count showed normocytic normochromic anemia and leukocytosis with shift to the right. Radiographic and endoscopic examinations were not noteworthy. Endoscopic biopsy after a histopathological evaluation showed no cellular or tissue atypia. On the other hand, abdominal ultrasound assessment revealed thickening with loss of echotexture and definition of the muscular layer of the gastric wall, pyloric and duodenum region compatible with benign antral muscle hypertrophy and/or pyloric neoplasia. The animal worsened 5 days after the initial treatment, with progressive episodes of emesis and melena, opting for an exploratory laparotomy. A mass of firm consistency measuring approximately 2.5 × 6.0 cm in diameter was found in the pyloric region, opting for a pylorectomy. The excised fragment was sent for histopathological...(AU)

Three-dimensional laparoscopic Roux-en-Y gastric bypass with totally hand-sewn anastomoses for morbid obesity. A single center experience

Purpose To assess the impact of three-dimensional (3D) vision use on operative time (OT) in laparoscopic Roux-en-Y gastric bypass (LRYGB) with hand-sewn anastomoses. Methods We analyzed a prospectively collected database of patients who underwent LRYGB. We included all patients operated on with either 2D or 3D vision. Demographics and clinical characteristics, operative time, hospital stay and 30-day postoperative complications were collected for all patients and analyzed. Results During the study time, out of 143 patients who underwent LRYGB for morbid obesity, 111 were considered eligible. Seventy-eight patients were operated with 2D vision and 33 patients with 3D vision. Demographics and clinical characteristics were not different among groups. Mean OT was 203±51 and 167±32 minutes in the 2D and 3D groups respectively (p<0.001). Multivariate analyses showed that increasing age and BMI were independently related to prolonged OT, while 3D vision (OR 6.675, 95% CI 2.380-24.752, p<0.001) was strongly associated with shorter OT. Conclusions The use of 3D vision in LRYGB significantly reduced the OT, though intra- and postoperative complication rates and the length of hospital stay were not affected. Despite its limitations, our study supports the value of 3D vision laparoscopy in bariatric surgery.(AU)