Macro and microscopic comparison of the upper pole of the spleen with the lower pole in partial splenectomy

Purpose To evaluate the viability of the upper (UP) and lower pole (LP) of the spleen from a macro and microscopic point of view, after subtotal splenectomy with preservation (SSP) of the UP and the LP. Methods Seventeen male Wistar rats, two months old, were submitted to SSPUP and SSPLP and 5 to simulated operation (SG). After 80 days, the rats were euthanized, and the remaining LP and UP and intact spleens were evaluated macroscopically and microscopically. Results Two rats died during the operation. Macroscopic analysis showed that in 15 LP, one of them was not viable and in 15 UP and in 5 spleens in the SG, all were viable. In the statistical analysis, there was no difference in relation to viability. The LP and UP analyzed showed variation. As for the length, the UP increased significantly; however, in relation to the width, there was a significant increase in the LP in relation to the UP. In addition, the weight of the UP was significantly greater than that of the LP. Microscopic analysis attested viability of the splenic remnants. Conclusion There was no significant difference regarding the viability of UP and LP, in macroscopy and microscopy.(AU)

Laparoscopic bowel resection of deep infiltrating endometriosis: comparative outcomes of a public teaching hospital and a referral private hospital

Purpose To compare the operative outcomes of laparoscopic surgical treatment for bowel endometriosis in a public teaching hospital versus in a private referral hospital. Methods The indications for surgery, type and time of operation, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, and postoperative complications were evaluated. Results One hundred eighty-one patients were included (150 patients, 82.9%, in a private hospital). In the private hospital, there were more patients with infertility [56% vs. 29%; P=0.01] as an indication for surgery) and segmental resection was more common in the private hospital (48% vs. 29%, p=0.05). The average operative time (211.9±83.4 minutes vs. 128 ± 55 minutes, p 0.001) as well as the length of hospital stay (3.97±1.7 days vs. 1.56±0.85 days, p 0.001) was higher in the public hospital; the rate of conversion to open surgery was significantly lower in the private hospital (2% vs. 32.3%, p 0.001). Operations performed at the public hospital were associated with higher rates of postoperative complications (Clavien-Dindo II and II) (38.7% x 11.3%, p=0.021; OR 3.2, CI 95% 1.2-8.0). Conclusion Laparoscopic surgery in private centers was associated with reductions in major complications, surgical times, lengths of stay and rates of conversion to open surgery compared to that in public teaching hospitals.(AU)

The alternative model of silicone for experimental simulation of suture of living tissue in the teaching of surgical technique

Purpose: To develop a silicone alternative model of tissue suture simulation to be used in the teaching of surgical technique. Methods: Twelve alternative models of silicone for tissue suture simulation were manufactured and implemented as a tool for suture pattern training of undergraduate medical students of Universidade Federal do Amazonas. Forty-eight students participated in the research. The evaluation of the proposed model was done through a questionnaire using the Likert scale, in order to verify the student satisfaction index of the alternative resource and its performance as opposed to the model historically used in the discipline, which is to suture in cloths. Results: The alternative model showed satisfactory results, especially with respect to the structural aspect, such as, better perception of anatomical planes, handling and transport. About 89.58% of positive concordant responses demonstrating expressive approval for incorporation of a complementary form of the alternative methodological proposal of the discipline of surgical technique. Conclusions: The model developed for experimental simulation of tissue sutures has proved to be a fully feasible alternative method for the training of this surgical skill. It is a simple, reproducible and low-cost model.(AU)

Experience report on teaching surgical technique without animal use

PURPOSE: To report the experience of the school in implementing the 3 Rs replace, reduce and refine; showing time and assembling cost of the experimental models used in the teaching of Surgical Technique and Experimental Surgery.METHODS: Assembly time and costs of models: grafts and flaps performed in pork belly, model of intestinal anastomosis and jejunostomy done in Bahiana box and black box model for training videosurgery.RESULTS: Average time and cost estimate: ten minutes-pork belly, cost $ 6.00 per kilogram; two minutes-Bahiana box, cost $ 27.2; Black box-3.6 hours for manufacturing, cost $ 100.00. The repetition of each practice the cost is $ 3.20 for Bahiana box and at no cost to the black box.CONCLUSION:The experimental models presented are easily reproducible and of low cost.(AU)

Surgical research in the north and northeast of Brazil

PURPOSE: To evaluate the scientific production from the surgical areas from the State University of Para (UEPA), Federal Universities of Para (UFPA) and of Paraiba (UFPB), Brazil. METHODS: The scientific productions of professors in the last five years were classified according to the Qualis system of CAPES-Medicine III (http://qualis.capes.gov.br/webqualis/publico/pesquisaPublicaClassificacao.seam?conversationPropagation=begin) and it was computed the number of guidance of students scientific projects. RESULTS: Seventy-four professors were included, 31 with Master and 43 with PhD degrees. UFPA presented more publications (49% out of the total), which 32% of them in Journals B1 or higher. Otorhinolaryngology presented the greatest number of publications (29% out of the total); however, 98% of them in B3 or lower. Gastroenterological Surgery, which is responsible for 23% out of the total, had 57% of its publications in B1 or higher. The most frequent type of guidance was the one about scientific work of completion of undergraduate course (63%). Gynecology and Obstetrics presented the greatest number of student's guidance (35% out of the total) and Gastroenterological Surgery the largest number of Master's degree and PhD degree supervisions. CONCLUSIONS: The specialties Gynecology and Obstetrics and Gastroenterological Surgery from the State University of Para (UEPA), Federal Universities of Para (UFPA) and of Paraiba (UFPB) presented the greatest number of professors with academic degrees. Gastroenterological Surgery presented the largest scientific productions at higher strata of WebQualis CAPES classification and also the largest number of Master and PhD directed.(AU)

Brazilian Scientific Journals in Surgery: quality control in the abstract structure of non-experimental articles

PURPOSE: To evaluate the quality of abstracts of original non-experimental research articles in Brazilian Journals in Surgery. METHODS: Convenience sample of 471 abstracts of original research articles from six Brazilian surgical journals indexed in Thomson Reuters (ISI) Web of Knowledge. The quality of abstracts was measured against a checklist of eight evaluation criteria, which were divided into 32 categories. The total score for each abstract was obtained by summing the score of all criteria present. The overall mean score was also determined. RESULTS: The overall mean score of abstract quality was that of a good abstract. Most of the abstracts contained some information from each of the eight basic categories of an abstract. All abstracts were structured ones. CONCLUSION: The overall quality, for abstracts of original articles of six Brazilian non-experimental journals in surgery, was classified as good.(AU)