Long-term assessment of a modified tibial tuberosity advancement technique in dogs / Avaliação em longo prazo da técnica de avanço da tuberosidade tibial modificada em cães

The purpose of study was to assess long-term clinical and radiographic aspects of dogs' stifle joints which had undergone a modified tibial tuberosity advancement technique (mTTA). A total of 15 stifles that had undergone mTTA for CCL disease of 11 patients were included in this study. Assessments involved patient's gait analysis, cranial drawer and tibial compression tests, stifle goniometry range of articular motion, thigh and leg girth and radiographic evidence of progression of osteoarthrosis. Variables were compared between operated and healthy limbs and among moments (M0) on the early postop; (M1) 120 days postop; and (M2) approximately 5 years following surgery. A questionnaire regarding owner's perceptions after approximately 5 years of surgery was assessed. Most dogs presented positive response to cranial drawer and tibial compression tests on operated knees. There was also decrease on goniometry and thigh girth and increase in leg girth. Radiographic evidence of progression of osteoarthritis was seen especially on the long-term follow-up (M2). On gait analysis, most animals presented some degree of lameness in different conditions, in contrast to owners' perceptions. Osteoarthritis still develops in dogs following mTTA surgery for CCL disease. However, owners were overall satisfied with their recovery and would be willing to accept indication of mTTA for dogs with ruptured CCL.(AU)

O objetivo deste estudo foi avaliar, em longo prazo, aspectos clínicos e radiográficos do joelho de cães submetidos à técnica modificada de avanço da tuberosidade da tíbia (mTTA). Um total de 15 joelhos de 11 pacientes foram submetidos à mTTA para correção de doença do ligamento cruzado cranial. A avaliação envolvia análise de marcha do paciente, teste de compressão tibial e de gaveta, goniometria do joelho para amplitude articular, circunferência das pernas e coxas e evidência radiográfica de progressão da osteoartrose. As variáveis foram comparadas entre membros operados e saudáveis e entre os momentos (M0) no pós-operatório imediato; (M1) 120 dias de pós-operatório; e (M2) aproximadamente cinco anos após a cirurgia. Foi avaliado um questionário sobre as percepções do proprietário após aproximadamente cinco anos de cirurgia. A maioria dos cães apresentou resposta positiva aos testes de gavetas e de compressão tibial em joelhos operados. Houve também diminuição na goniometria e na circunferência da coxa e aumento do perímetro das pernas. Evidências radiográficas de progressão da osteoartrite foram observadas especialmente no seguimento de longo prazo (M2). Na análise de marcha, a maioria dos animais apresentou algum grau de claudicação em diferentes condições, em contraste com as percepções dos proprietários. A osteoartrite ainda se desenvolve em cães após a cirurgia de mTTA para doença CCL. No entanto, os proprietários estavam, em geral, satisfeitos com a recuperação dos animais e estavam dispostos a aceitar a indicação de mTTA para cães com doença do ligamento cruzado cranial.(AU)

Long-term assessment of a modified tibial tuberosity advancement technique in dogs / Avaliação em longo prazo da técnica de avanço da tuberosidade tibial modificada em cães

The purpose of study was to assess long-term clinical and radiographic aspects of dogs' stifle joints which had undergone a modified tibial tuberosity advancement technique (mTTA). A total of 15 stifles that had undergone mTTA for CCL disease of 11 patients were included in this study. Assessments involved patient's gait analysis, cranial drawer and tibial compression tests, stifle goniometry range of articular motion, thigh and leg girth and radiographic evidence of progression of osteoarthrosis. Variables were compared between operated and healthy limbs and among moments (M0) on the early postop; (M1) 120 days postop; and (M2) approximately 5 years following surgery. A questionnaire regarding owner's perceptions after approximately 5 years of surgery was assessed. Most dogs presented positive response to cranial drawer and tibial compression tests on operated knees. There was also decrease on goniometry and thigh girth and increase in leg girth. Radiographic evidence of progression of osteoarthritis was seen especially on the long-term follow-up (M2). On gait analysis, most animals presented some degree of lameness in different conditions, in contrast to owners' perceptions. Osteoarthritis still develops in dogs following mTTA surgery for CCL disease. However, owners were overall satisfied with their recovery and would be willing to accept indication of mTTA for dogs with ruptured CCL.(AU)

O objetivo deste estudo foi avaliar, em longo prazo, aspectos clínicos e radiográficos do joelho de cães submetidos à técnica modificada de avanço da tuberosidade da tíbia (mTTA). Um total de 15 joelhos de 11 pacientes foram submetidos à mTTA para correção de doença do ligamento cruzado cranial. A avaliação envolvia análise de marcha do paciente, teste de compressão tibial e de gaveta, goniometria do joelho para amplitude articular, circunferência das pernas e coxas e evidência radiográfica de progressão da osteoartrose. As variáveis foram comparadas entre membros operados e saudáveis e entre os momentos (M0) no pós-operatório imediato; (M1) 120 dias de pós-operatório; e (M2) aproximadamente cinco anos após a cirurgia. Foi avaliado um questionário sobre as percepções do proprietário após aproximadamente cinco anos de cirurgia. A maioria dos cães apresentou resposta positiva aos testes de gavetas e de compressão tibial em joelhos operados. Houve também diminuição na goniometria e na circunferência da coxa e aumento do perímetro das pernas. Evidências radiográficas de progressão da osteoartrite foram observadas especialmente no seguimento de longo prazo (M2). Na análise de marcha, a maioria dos animais apresentou algum grau de claudicação em diferentes condições, em contraste com as percepções dos proprietários. A osteoartrite ainda se desenvolve em cães após a cirurgia de mTTA para doença CCL. No entanto, os proprietários estavam, em geral, satisfeitos com a recuperação dos animais e estavam dispostos a aceitar a indicação de mTTA para cães com doença do ligamento cruzado cranial.(AU)

Student insight about the discipline of surgical technique on the formative process in the School of Medicine of UFRJ

Purpose: To evaluate whether undergraduate students feel motivated to develop surgical skills and know their impression about the importance of having a surgical technique discipline in the curriculum of a medical school. Methods: A prospective study including three classes in a row, from the 8th period (n = 265) evaluated the knowledge acquired at the Center of Experimental Surgery, Department of Surgery, School of Medicine of Federal University of Rio de Janeiro (UFRJ). The importance of the discipline for medical training as a way of encouragement to arouse and deepen the interest in surgical technique was emphasized. The questions were scored from 1 to 5 (worst to best grade) . Results: Concerning the importance of the discipline for medical training, 78% and 18% of the students assigned a score 5 and 4, respectively. Regarding the stimulus to improve their surgical technical skills, 40% and 32% attributed the score 5 and 4, respectively. Conclusion: Undergraduate students from the Medical School of UFRJ effectively shared the understanding that the operative technique bases improve the formative process with significant impact, not only in the development of skills, but also to arouse vocations and stimulate new attitudes aimed to knowledge acquirement in the field of Surgery.(AU)

Surgical model pig ex vivo for venous dissection teaching in medical schools

Purpose: To investigate a method for development of surgical skills in medical students simulating venous dissection in surgical ex vivo pig model. Methods: Prospective, analytical, experimental, controlled study with four stages: selection, theoretical teaching, training and assessment. Sample of 312 students was divided into two groups: Group A - 2nd semester students; Group B - students of 8th semester. The groups were divided into five groups of 12 students, trained two hours per week in the semester. They set up four models to three students in each skill station assisted by a monitor. Teaching protocol emergency procedures training were applied to venous dissection, test goal-discursive and OSATS scale. Results: The pre-test confirmed that the methodology has not been previously applied to the students. The averages obtained in the theoretical evaluation reached satisfactory parameters in both groups. The results of applying OSATS scale showed the best performance in group A compared to group B, however, both groups had satisfactory medium. Conclusion: The method was enough to raise a satisfactory level of skill both groups in venous dissection running on surgical swine ex vivo models.(AU)

Survival analysis of female dogs with mammary tumors after mastectomy: epidemiological, clinical and morphological aspects / Análise de sobrevivência de cadela com tumores mamários após mastectomia: aspectos epidemiológicos, clínicos e morfológicos

Mammary gland tumors are the most common type of tumors in bitches but research on survival time after diagnosis is scarce. The purpose of this study was to investigate the relationship between survival time after mastectomy and a number of clinical and morphological variables. Data was collected retrospectively on bitches with mammary tumors seen at the Small Animal Surgery Clinic Service at the University of Brasília. All subjects had undergone mastectomy. Survival analysis was conducted using Cox's proportional hazard method. Of the 139 subjects analyzed, 68 died and 71 survived until the end of the study (64 months). Mean age was 11.76 years (SD=2.71), 53.84% were small dogs. 76.92% of the tumors were malignant, and 65.73% had both thoracic and inguinal glands affected. Survival time in months was associated with age (hazard rate ratios [HRR] =1.23, p-value =1.4x10-4), animal size (HRR between giant and small animals =2.61, p-value =0.02), nodule size (HRR =1.09, p-value =0.03), histological type (HRR between solid carcinoma and carcinoma in a mixed tumor =2.40, p-value =0.02), time between diagnosis and surgery (TDS, with HRR =1.21, p-value =2.7x10-15), and the interaction TDS*follow-up time (HRR =0.98, p-value =1.6x10-11). The present study is one of the few on the subject matter. Several important covariates were evaluated and age, animal size, nodule size, histological type, TDS and TDS*follow up time were identified as significantly associated to survival time.(AU)

Os tumores da glândula mamária são o tipo mais comum de tumores em cadelas, porém, estudos sobre o tempo de sobrevida após o diagnóstico são escassos. Objetivou-se investigar a relação entre o tempo de sobrevida após a mastectomia, bem como variáveis clínicas e populacionais. Coletaram-se dados retrospectivos referentes a cadelas com tumores mamários atendidos no Serviço de Clínica Cirúrgica de Pequenos Animais da Universidade de Brasília e submetidas à mastectomia. A análise de sobrevida foi realizada mediante o método de Cox de risco proporcional. Dos 139 animais incluídos neste estudo, 68 morreram e 71 sobreviveram até ao final da conclusão deste traballho (64 meses). A média de idade foi de 11,76 anos (DP=2,71), 53,84% dos cães eram pequenos. Dentre os tumores, 76,92% eram malignos, e 65,73% tiveram as duas glândulas torácicas e a inguinal afetadas. O tempo de sobrevida em meses foi associado à idade (taxa de razão de risco [HRR] =1,23, p valor =1.4x10-4), o tamanho do animal (HRR entre animais gigantes e pequenos = 2,61, p=0,02), tamanho do nódulo (HRR=1,09, p valor =0,03), tipo histológico (HRR entre carcinoma sólido e carcinomas em tumor misto =2,40, p=0,02), tempo decorrido entre o diagnóstico e a cirurgia (TDC, com HRR =1,21, p valor =2,7 x10-15), e a interação TDC*tempo de seguimento (HRR = 0,98, p valor = 1.6x10-11). O presente estudo é um dos poucos sobre o assunto. Várias covariáveis importantes foram avaliadas e idade, tamanho do animal, o tamanho do nódulo, tipo histológico, TDC e TDC*tempo de seguimento foram identificados como significativamente associado ao tempo de sobrevida.(AU)

Como enfrentar os obstáculos frequentes em éguas portadores de alterações genitais passíveis de tratamento cirúrgico / Facing the most frequent challenges in mares with genital alterations that may be corrected by surgery

Para entender a enfrentar os desafios do ato cirúrgico torna-se necessário a leitura obrigatória do livro “O século dos cirurgiões”, onde o autor descreveu os primórdios dos procedimentos antes e após o advento e descoberta das drogas anestésicas, as técnicas cruentas utilizadas na época, as amputações, a operação cesariana, a comprovação da contaminação bacteriana e os princípios da antissepsia (Thorwald, 2010). As dificuldades em improvisações enfrentadas pelos praticantes pioneiros da medicina veterinária equina estão historicamente relatadas no livro “Ars Veterinária” detalhadamente compiladas por Walker (1991), onde escreveu uma narrativa da importância do cavalo na história do ser humano e sua utilização como meio de transporte, lazer e atividade militar nas grandes batalhas principalmente dos exploradores e dos impérios greco-romano, contendo ilustrações do instrumental cirúrgico artesanal utilizado na época. O objetivo desse texto será o de apresentar uma súmula dos principais obstáculos enfrentados nas cirurgias do trato reprodutivo das éguas sem a pretensão de esgotar o assunto, mas sim deixar registrado uma parte da experiência pessoal deste profissional embasado na literatura especializada.(AU)

In order to face the challenges of surgical act, reading Jürgen Thorwald's book “The Century of the Surgeon” (Das Jahrhundert der Chirurgen) is a must. In his book, the author describes the beginning of surgical procedures before and after the discovery of anaesthetic drugs, the bloody techniques used in those times, the amputations, the caesarean section, the evidence of bacterial contamination, and the principles of antisepsis (Thorwald, 2010). The difficulties and improvisations faced by the pioneers in equine medicine are historically reported in the book “ArsVeterinaria”, carefully reported by Walker (1991), who tells about the importance of horses in human history and about the use of those animals for transportation, leisure and military purposes, specially on great battles involving explorers and the Greek-Roman empire, including illustrations of the handmade surgical instruments used in that time. The aim of this text is to present a summary of the main obstacles faced in mares reproductive surgery, with no pretension to exhaust the subject, but to report part of the personal experience of this professional, grounded in specialized literature.(AU)

Como enfrentar os obstáculos frequentes em éguas portadores de alterações genitais passíveis de tratamento cirúrgico / Facing the most frequent challenges in mares with genital alterations that may be corrected by surgery

Para entender a enfrentar os desafios do ato cirúrgico torna-se necessário a leitura obrigatória do livro “O século dos cirurgiões”, onde o autor descreveu os primórdios dos procedimentos antes e após o advento e descoberta das drogas anestésicas, as técnicas cruentas utilizadas na época, as amputações, a operação cesariana, a comprovação da contaminação bacteriana e os princípios da antissepsia (Thorwald, 2010). As dificuldades em improvisações enfrentadas pelos praticantes pioneiros da medicina veterinária equina estão historicamente relatadas no livro “Ars Veterinária” detalhadamente compiladas por Walker (1991), onde escreveu uma narrativa da importância do cavalo na história do ser humano e sua utilização como meio de transporte, lazer e atividade militar nas grandes batalhas principalmente dos exploradores e dos impérios greco-romano, contendo ilustrações do instrumental cirúrgico artesanal utilizado na época. O objetivo desse texto será o de apresentar uma súmula dos principais obstáculos enfrentados nas cirurgias do trato reprodutivo das éguas sem a pretensão de esgotar o assunto, mas sim deixar registrado uma parte da experiência pessoal deste profissional embasado na literatura especializada.

In order to face the challenges of surgical act, reading Jürgen Thorwald's book “The Century of the Surgeon” (Das Jahrhundert der Chirurgen) is a must. In his book, the author describes the beginning of surgical procedures before and after the discovery of anaesthetic drugs, the bloody techniques used in those times, the amputations, the caesarean section, the evidence of bacterial contamination, and the principles of antisepsis (Thorwald, 2010). The difficulties and improvisations faced by the pioneers in equine medicine are historically reported in the book “ArsVeterinaria”, carefully reported by Walker (1991), who tells about the importance of horses in human history and about the use of those animals for transportation, leisure and military purposes, specially on great battles involving explorers and the Greek-Roman empire, including illustrations of the handmade surgical instruments used in that time. The aim of this text is to present a summary of the main obstacles faced in mares reproductive surgery, with no pretension to exhaust the subject, but to report part of the personal experience of this professional, grounded in specialized literature.

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)

Behavioural and cognitive effects of simvastatin dose used in stimulation of bone regeneration in rats

To analyze the effects of simvastatin (SVT) in the locomotion, anxiety and memory of rats, as a reflection of the administration of a minimum dose capable of stimulating bone regeneration in defects in the calvariae. METHODS: Surgical procedures were performed in 15 female Wistar rats, 2-month old, to insert the grafting material regenerator (Bone-ceramic(r)) and/or SVT, followed by behavioural and cognitive assessments in the 7th, 30th and 60th days post surgery. RESULTS: The SVT locally applied with the goal of bone regeneration in defects created in rat calvariae does not interfere with locomotion, anxiety levels and/or memories of rats, except for the first week following surgery, when an anxiolytic effect was observed, as a result of a possible central action. CONCLUSION: Failure to provoke any response within 30 and 60 days post surgical procedures suggests that SVT may constitute a good choice in stimulating bone regeneration without affecting the long term neural functions.(AU)

Simulation-based ultrasound-guided central venous cannulation training program

To propose a simulation-based ultrasound-guided central venous cannulation skills' training program, during residency. METHODS: This study describes the strategies for learning the ultrasound-guided central venous cannulation on low-fidelity bench models. The preparation of bench models, educational goals, processes of skill acquisition, feedback and evaluation methods were also outlined. The training program was based on key references to the subject. RESULTS: It was formulated a simulation-based ultrasound-guided central venous cannulation teaching program on low-fidelity bench models. CONCLUSION: A simulation-based inexpensive, low-stress, no-risk learning program on low-fidelity bench models was proposed to facilitate acquisition of ultrasound-guided central venous cannulation skills by residents-in-training before exposure to the living patient.(AU)

The effect of different doses of chloroprocaine on saddle anesthesia in perianal surgery

To investigate a saddle anesthesia with different doses of chloroprocaine in perianal surgery. METHODS: Total 60 Patients aged 18-75 years (Anesthesiologists grade I or II) scheduled to receive perianal surgery. Patients using saddle anesthesia were randomized to group A, group B and group C with the same concentration (0.5%) chloroprocaine with different doses 1.0 mL, 0.8 mL and 0.6 mL, respectively. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and the sensory and motor block were recorded to evaluate the anesthesia effect of chloroprocaine in each group. RESULTS: The duration of sensory block of group C is shorter than those of group A and B. The maximum degree of motor block is observed (group C: 0 level, group A: III level; and group B: I level) after 15 minutes. Besides, there was a better anesthetic effect in group B than group A and group C, such as walking after saddle anesthesia. However, there is also no significant difference of blood pressure decreasing in these three groups. CONCLUSION: It's worth to employ a saddle anesthesia with appropriate doses of chloroprocaine in clinical perianal surgery.(AU)

Effects of cholecystectomy on the changes of motility of Beagle dogs' sphincter of Oddi

To observe the effect of cholecystectomy on the changes of motion pattern of Beagle dogs' sphincter of Oddi (SO), and investigate the modulatory role of nitric oxide (NO) and cholecystokinin (CCK) in the regulation of SO. Pressure of common bile duct, SO motility, response to bolus injections of cholecystokinin (CCK, 20 ng/kg and 100 ng/kg), basal pressure (BP) and phasic contraction amplitude (PCA) were measured respectively by manometry in six Beagle dogs before and after cholecystectomy. After cholecystectomy, the pressure and diameter of common bile ducts (CBD) was significantly increased (p<0.01); BP and phasic contraction frequency (PCF) were also increased, however, no significant differences were found between the two groups; the SO motilities was not significantly changed. The relaxation responded to physiological dose of CCK (20ng/kg) was decreased, while bolus-dose of CCK (100ng/kg) induced rapid contractions and decreased PCA after cholecystectomy. The regulation pattern of SO pressure modulated by NO and its inhibitor had changed after cholecystectomy. CONCLUSION: After cholecystectomy in Beagle dogs, no obviously change of motion pattern of SO was observed through self-compensation, but these compensations may lead to some changes of regulation pattern of CCK and NO on SO.(AU)

O uso do peritônio de paca conservado em solução supersaturada de açúcar a 300 por cento ou glicerina a 98 por cento implantados na parede abdominal de ratos / The use of paca peritoneum preserved in supersaturated sugar solution 300 percent or glycerine 98 percent implanted in the abdominal wall of rats

Na busca de material biológico alternativo para a realização de implantes, objetivou-se com o presente estudo avaliar comparativamente a implantação do peritônio de paca, uma nova opção de biomaterial, conservado em solução supersaturada de açúcar a 300 por cento e conservado em glicerina a 98 por cento na parede abdominal de ratos Wistar. Foram utilizados 60 ratos, machos, da linhagem Wistar, pesando entre 150 e 200 gramas, organizados nos seguintes grupos experimentais: grupo controle (GI), grupo peritônio conservado em solução supersaturada de açúcar a 300 por cento (GII) e grupo peritônio conservado em glicerina a 98 por cento (GIII), cada um com 20 animais. Os grupos GII e GIII receberam o enxerto de peritônio da paca conservado em solução de açúcar 300 por cento e glicerina 98 por cento, respectivamente, e o grupo GI não recebeu a membrana. Cinco ratos de cada grupo foram submetidos à eutanásia em quatro momentos distintos: sete, 15, 30 e 60 dias de pós-operatório para avaliações macroscópicas e microscópicas da interface implante-tecido nativo. Apesar de reações adversas observadas em 57,5 por cento dos animais do grupo GII e GIII, em 95 por cento dos animais desses grupos houve boa cicatrização da membrana. Na análise histológica, verificou-se a presença de grande infiltrado inflamatório nos períodos iniciais (sete e 15 dias) e grande presença de tecido conjuntivo nos momentos finais (30 e 60 dias). Concluiu-se que o peritônio da paca como membrana biológica conservado nos meios estudados pode ser utilizado com segurança na parede abdominal de ratos; ainda, que sua conservação em solução supersaturada de açúcar a 300 por cento permitiu melhor maleabilidade no ato cirúrgico.(AU)

In the search for alternative biological material to perform implants, this study aimed to compare the implantation of paca peritoneum, a new biomaterial option, preserved in supersaturated sugar solution 300 percent and preserved in glycerin 98 percent in the abdominal wall of Wistar rats. A total of 60 male rats from the Wistar strain weighing between 150 and 200 grams were housed into three different experimental groups: control group (GI), peritoneum preserved in supersaturated sugar solution 300 percent group (GII) and peritoneum preserved in glycerin 98 percent group (GIII), with 20 animals each. The GII and GIII received the paca peritoneum graft preserved in sugar solution 300 percent and glycerin 98 percent, respectively and group GI did not receive any membrane. Five rats from each group were euthanized at four different times: seven, 15, 30 and 60 days post-surgery for macroscopic and microscopic evaluations in graft-native tissue interface. Despite the adverse reactions observed in 57.5 percent of GII and GIII, there was good healing of the membrane in 95 percent of the animals in these groups. Upon histological examination there was a large presence of inflammatory infiltrates in the initial periods (seven and 15 days) and a large presence of connective tissue in the final stages (30 and 60). It was concluded that the paca peritoneum as biological membrane preserved as presented in this study can be used safely in the abdominal wall of rats, the preservation in supersaturated sugar solution 300 percent allowed better flexibility during surgery.(AU)

Micro-endoscopic ear anatomy of guinea pig applied to experimental surgery

PURPOSE: To describe topographic and endoscopic anatomy of guinea pig ear for development of surgical approaches in experimental studies. METHODS: Experimental study. Eight adult guinea pigs (Cavia porcellus) were used in this study. Four animals were described through endoscopic view and four animals were used to describe topographic anatomy. RESULTS: The main structures of middle ear were well identified through endoscopy view: oval and round window, ossicles and vascular structures. Temporal bone position, landmarks and its relations to skull are perceived with topographic description. CONCLUSION: Topographic anatomic description allowed exposition of temporal bone relations for external surgical approaches. Alternatively, grooves and middle ear structures were identified and may be used to transcanal accesses. .(AU)

Comparison between transsylvian-transinsular and transcortical-transtemporal approach for evacuation of intracerebral hematoma

PURPOSE: Hypertensive cerebral hemorrhage in the basal ganglia is a potentially life-threatening cerebrovascular disease with high mortality. Surgical evacuation is an important treatment for intracerebral hemorrhage. However, little is reported about the comparison on the efficacy of various approaches on the prognosis. METHODS: Clinical data of 80 cases of intracerebral hemorrhage which surgically treated via transsylvian-transinsular approach or transcortical-transtemporal approach were collected. The proportion of post-surgery tracheostomy, incidence of digestive tract hemorrhage, revision surgery, the average length of hospital stay, and the six-month efficacy (defined by an ADL score) rate between these two groups were compared. RESULTS: The six-month efficacy rates were 75% and 50% in patients receiving transsylvian-transinsular and transcortical-transtemporal surgery, respectively (p<0.05). Compared to the transcortical-transtemporal group, the proportion of revision surgery was statistically significantly lower in the transsylvian-transinsular group, (p<0.05). The proportion of post-surgery tracheostomy, the incidence of digestive tract hemorrhage, and the average length of hospital stay were lower in the transsylvian-transinsular group, compared to the transcortical-transtemporal group, but no statistically significant differences were noted in them between the two groups. CONCLUSION: The transsylvian-transinsular approach for evacuation of intracerebral hematoma demonstrates limited complications, shorter length of hospital stay, and improved long-term efficacy and prognosis. These findings suggest this operative approach has potential for wider application.(AU)

Ruptura de bexiga em um cão: relato de caso / Bladder rupture in a dog: case report

A ruptura de bexiga é uma das anomalias do trato urinário mais recorrente nos cães e nos gatos, e pode ser causada por diferentes fatores, como trauma, necrose ou alguma complicação durante uma cirurgia vesical. Como conseqüência, ocorre o uroperitônio que, em longo prazo, leva à uremia, desidratação, hipovolemia, hipercalemia e morte (FOSSUM, 2008). O objetivo deste trabalho é relatar um caso clínico-cirúrgico de uma ruptura de bexiga em um cão da raça Fila Alemão.

Bench surgical training with lyophilized esophageal segments

PURPOSE: To present lyophilized esophageal segments that can be used to learn surgical skills. METHODS: Four esophagus were harvested from four non-esophagus related research dogs at the moment of euthanasia. Each esophagus was trimmed in 3 cm long segments. They were lyophilized and stored during 30 days. The day programmed for surgical skills practice, they were rehydrated. RESULTS: Sixteen segments have been used. After rehydrating, all the segments kept their normal anatomic shape and structural integrity. One incision was made on every esophageal segment and sutured with running stitches of 3-0 polyglactin 910. There were no complications, such as tissue tears, nor esophageal hardening. CONCLUSIONS: The lyophilized esophagus is a high fidelity, practical, reproducible, portable, low-cost bench model. It allows general surgery apprentices to learn how to handle an esophagus, as well as to perfect their surgical and suture abilities before applying them on real patient's esophagus.(AU)

Ruptura de bexiga em um cão: relato de caso / Bladder rupture in a dog: case report

A ruptura de bexiga é uma das anomalias do trato urinário mais recorrente nos cães e nos gatos, e pode ser causada por diferentes fatores, como trauma, necrose ou alguma complicação durante uma cirurgia vesical. Como conseqüência, ocorre o uroperitônio que, em longo prazo, leva à uremia, desidratação, hipovolemia, hipercalemia e morte (FOSSUM, 2008). O objetivo deste trabalho é relatar um caso clínico-cirúrgico de uma ruptura de bexiga em um cão da raça Fila Alemão.(AU)

Decompressive fasciotomy in testicular torsion of the spermatic cord in rats

PURPOSE: To evaluate the effect of decompression fasciotomy on testes undergoing torsion of the spermatic cord. METHODS: Spermatic cord torsion was induced in 40 Wistar testes for six and 12 hours. At the time of distortion, decompression fasciotomy was performed on half of the animals. After 42 days, the testicles were examined both macroscopically and microscopically. A non-parametric Mann- Whitney U- test was used for statistical analysis. The results were considered significant at p≤0.05. RESULTS: Testicular weight; volume and degree of histological alterations were evaluated. When the groups without and with fasciotomy were compared, a 12-hour torsion subgroup in the fasciotomy group was noted to present larger volume, heavier weight and superior histological classification when compared with the 12-hour subgroup in the without fasciotomy group. No differences between the two groups after six hours of torsion were found. No significant changes were noticed in the contralateral testis. CONCLUSIONS: Testicular fasciotomy (decompression) benefited the macroscopic and histological aspects of the testicles undergoing cord torsion for a 12-hour period. These results demonstrate the role played by compartment syndrome in the pathophysiology of spermatic cord torsion and the need for decompression.(AU)

Evaluation of breathing exercise in hormonal and immunological responses in patients undergoing abdominal surgery

PURPOSE: To evaluate the effects of sustained deep inspiration in the prevention of postoperative pulmonary complications, the hormonal and immunological responses in patients submitted to abdominal surgery. METHODS: This randomized clinical trial study included 75 patients submitted to abdominal surgery, of which 36 were randomly allocated in the experimental group and underwent sustained deep inspiration during five seconds, in three sets of ten repetitions per day. The others 39 patients were allocated in the control group and were not submitted to any breathing exercise. The following parameters were measured preoperatively, 24h and 48h postoperatively: chest x-ray, serum ACTH, cortisol, IL-4, IL-10, TNF-α, forced expiratory volume in first second (FEV1), forced expiratory flow 25-75% (FEF 25-75), forced vital capacity (FVC), paO2 and paCO2. RESULTS: Mean serum cortisol in patients of the experimental and control groups before surgery were 12.8 mcg/dl (4.6-50) and 10.48 mcg/dl (1-29.1), respectively (p=0.414). The experimental group had significantly increase in serum cortisol levels, 23.6 mcg/dl (9.3-45.8), especially 24h postoperatively (p=0.049). CONCLUSION: Sustained deep inspiration in patients submitted to abdominal surgery determined important changes in serum cortisol, however, without significantly influence the postoperative pulmonary complications and the endocrine and immune responses.(AU)