Thoracoscopy pulmonary biopsy by two portals with a novel pre-tied loop ligature device in rabbits: an experimental study / Biópsia pulmonar por toracoscopia por dois portais com uma nova ligadura de alça pré-amarrada em coelhos: um estudo experimental

Thoracoscopy is replacing open lung biopsies because it is less invasive, usually the technique is done using three portals and intracorporeal suture technique. This study described the feasibility and efficacy of a novel pre tied loop ligature and to propose a thoracoscopic access strategy with two portals to perform lung biopsy in patients under 5 kg. Ten rabbits were positioned in dorsal recumbency. Total thoracoscopic lung biopsy was performed using a combined transdiaphragmatic approach and a right intercostal approach. A pre tied loop ligature was placed to perform a caudal lung lobe biopsy. Insufflation of the thoracic cavity was not performed. The total surgery time was 41.4 ± 14.5 min. The procedure was carried out free of complications that prevented slippage or tightening the knot or that made it come loose after the lung biopsy; there was no serious complication during the surgical procedure. The samples obtained averaged 1x0.64x0.45 cm (Length, Width, Depth) and were considered satisfactory according to the histopathologic evaluation. Thorax radiographs taken before and after the surgeries were compared and showed no pneumothorax or hemothorax. Necropsy confirmed no knot failure occurred at the biopsy site. The use of the novel pre tied loop ligature is a safe and effective technique, avoiding problems with the limited size of the thoracic cavity in small patients.

A toracoscopia está substituindo as biópsias pulmonares abertas por ser menos invasiva. Usualmente a técnica é feita utilizando três portais e ligaduras feitas intra corporalmente. O objetivo deste estudo foi descrever a viabilidade e eficácia de uma nova ligadura com alça pré-amarrada e propor uma estratégia de acesso toracoscópico com dois portais para realizar biópsia pulmonar em pacientes com menos de 5kg. Dez coelhos foram posicionados em decúbito dorsal. A biópsia pulmonar por toracoscopia total foi feita pela abordagem combinada transdiafragmática e abordagem intercostal direita. Uma nova ligadura pré-amarrada foi colocada para realizar uma biópsia do lobo pulmonar caudal. Não foi realizada insuflação da cavidade torácica. O tempo total de cirurgia foi de 41,4 ± 14,5 min. Os procedimentos foram realizados sem complicações que impedissem o escorregamento ou aperto do nó ou que o soltassem após a biópsia pulmonar; não houve nenhuma intercorrência grave durante o procedimento cirúrgico. As amostras coletadas tinham tamanho médio 1x0,64x0,45 cm e foram consideradas satisfatórias de acordo com a avaliação histopatológica. As radiografias de tórax feitas antes e depois das cirurgias foram comparadas e não mostraram pneumotórax ou hemotórax. A necropsia confirmou que não ocorreu falha do nó no local da biópsia. Conclui-se que uso da nova ligadura com alça pré-amarrada é uma técnica segura e eficaz, evitando problemas com o tamanho limitado da cavidade torácica em pacientes pequenos.

Thoracoscopy pulmonary biopsy by two portals with a novel pre-tied loop ligature device in rabbits: an experimental study / Biópsia pulmonar por toracoscopia por dois portais com uma nova ligadura de alça pré-amarrada em coelhos: um estudo experimental

ABSTRACT: Thoracoscopy is replacing open lung biopsies because it is less invasive, usually the technique is done using three portals and intracorporeal suture technique. This study described the feasibility and efficacy of a novel pre tied loop ligature and to propose a thoracoscopic access strategy with two portals to perform lung biopsy in patients under 5 kg. Ten rabbits were positioned in dorsal recumbency. Total thoracoscopic lung biopsy was performed using a combined transdiaphragmatic approach and a right intercostal approach. A pre tied loop ligature was placed to perform a caudal lung lobe biopsy. Insufflation of the thoracic cavity was not performed. The total surgery time was 41.4 ± 14.5 min. The procedure was carried out free of complications that prevented slippage or tightening the knot or that made it come loose after the lung biopsy; there was no serious complication during the surgical procedure. The samples obtained averaged 1x0.64x0.45 cm (Length, Width, Depth) and were considered satisfactory according to the histopathologic evaluation. Thorax radiographs taken before and after the surgeries were compared and showed no pneumothorax or hemothorax. Necropsy confirmed no knot failure occurred at the biopsy site. The use of the novel pre tied loop ligature is a safe and effective technique, avoiding problems with the limited size of the thoracic cavity in small patients.

RESUMO: A toracoscopia está substituindo as biópsias pulmonares abertas por ser menos invasiva. Usualmente a técnica é feita utilizando três portais e ligaduras feitas intra corporalmente. O objetivo deste estudo foi descrever a viabilidade e eficácia de uma nova ligadura com alça pré-amarrada e propor uma estratégia de acesso toracoscópico com dois portais para realizar biópsia pulmonar em pacientes com menos de 5kg. Dez coelhos foram posicionados em decúbito dorsal. A biópsia pulmonar por toracoscopia total foi feita pela abordagem combinada transdiafragmática e abordagem intercostal direita. Uma nova ligadura pré-amarrada foi colocada para realizar uma biópsia do lobo pulmonar caudal. Não foi realizada insuflação da cavidade torácica. O tempo total de cirurgia foi de 41,4 ± 14,5 min. Os procedimentos foram realizados sem complicações que impedissem o escorregamento ou aperto do nó ou que o soltassem após a biópsia pulmonar; não houve nenhuma intercorrência grave durante o procedimento cirúrgico. As amostras coletadas tinham tamanho médio 1x0,64x0,45 cm e foram consideradas satisfatórias de acordo com a avaliação histopatológica. As radiografias de tórax feitas antes e depois das cirurgias foram comparadas e não mostraram pneumotórax ou hemotórax. A necropsia confirmou que não ocorreu falha do nó no local da biópsia. Conclui-se que uso da nova ligadura com alça pré-amarrada é uma técnica segura e eficaz, evitando problemas com o tamanho limitado da cavidade torácica em pacientes pequenos.

Effects of oxygen supplementation in ewes subjected to laparoscopic ovum pick-up under total intravenous anesthesia / Efeitos da suplementação de oxigênio em ovelhas submetidas à aspiração de folículos por laparoscopia sob anestesia intravenosa total

Laparoscopy procedures are useful tools to perform some assisted reproductive biotechnologies in ewes, it requi-res general anesthesia and manoeuvres that might result in alteration of the cardiopulmonary function. For this reason, this study aimed to investigate the effects of oxygen supplementation as a therapeutic measure to mitigate these alterations in ewes submitted to laparoscopic ovum pick-up (LOPU) under total intravenous anesthesia (TIVA). Twenty-four healthy adult ewes were submitted to two LOPUs with a 21 days interval, under ketamine-midazolam anesthesia, and receiving each of the two experimental in random order, oxygen treatment (OT) 50 mL/kg/min of oxygen via endotracheal tube and control treatment (CT) not receive any inhalation treatment. Heart rate (HR), respiratory rate (fR), peripheral oxygen saturation (SpO2), mean arterial pressure (MAP), rectal temperature (RT), end-tidal CO2 concentration (EtCO2) and recovery anesthesia time were evaluated during LOPU, arterial blood gases and electrolytes were evaluated after induction of anesthesia and at the end of the LOPU. Variables were compared between groups and moments using ANOVA. MAP, SpO2, PaO2, SaO2 and pH were higher in OT, while EtCO2, PaCO2, temperature loss and recovery time were lower. These results allow to conclude that oxy-gen supplementation in ewes submitted to LOPU under TIVA provides benefits in order to mitigate physiological alterations.(AU)

Os procedimentos de laparoscopia são ferramentas úteis para realizar algumas biotecnologias de reprodução assistida em ovelhas, requer anestesia geral e manobras que podem resultar em alteração da função cardiopulmonar. Por esse motivo, este estudo teve como objetivo investigar os efeitos da suplementação de oxigênio como medida terapêutica para atenuar as alterações em ovelhas submetidas à Aspiração Folicular guiada por Laparoscopia (LOPU) sob anestesia venosa total (TIVA). Vinte e quatro ovelhas adultas saudáveis foram submetidas a duas LOPUs com intervalo de 21 dias, sob anestesia com cetamina-midazolam, recebendo cada um dos dois experimentos em ordem aleatória, tratamento com oxigênio (OT) 50 mL/kg/min de oxigênio via tubo endotraqueal e tratamento de controle (CT) não recebem nenhum tratamento por inalação. Frequência cardíaca (FC), frequência respiratória (FR), saturação periférica de oxigênio (SpO2), pressão arterial média (PAM), temperatura retal (TR), concentração expirada de CO2 (EtCO2) e tempo de recuperação da anestesia foram avaliados durante LOPU, arterial gasometria e eletrólitos foram avaliados após a indução da anestesia e ao final da COL. As variáveis foram comparadas entre grupos e momentos por meio de ANOVA. PAM, SpO2, PaO2, SaO2 e pH foram maiores no TO, enquanto EtCO2, PaCO2, perda de temperatura e tempo de recuperação foram menores. Estes resultados permitem concluir que a suplementação de oxigênio em ovelhas submetidas a LOPU sob TIVA proporciona benefícios no sentido de atenuar as alterações fisiológicas.(AU)

Experimental model of portal hypertension and esophagogastric varices in minipigs: pressure and endoscopic pilot study

Introduction: Portal hypertension still represents an important health problem worldwide. In the search for knowledge regarding this syndrome, experimental studies with animal models have proven to be useful to point the direction to be taken in future randomized clinical trials. Purpose: To validate the experimental model of portal hypertension and esophagogastric varices in a medium-sized animal. Methods: This study included five minipigs br1. Midline laparotomy with dissection of the portal vein and production of a calibrated stenosis of this vein was performed. Measurement of pressure in the portal venous and digestive endoscopic were performed before and five weeks after the production of a stenosis. Results: All animals were 8 months old, average weight of 17 ± 2.5 kg. The mean pressure of the portal vein immediately before the partial ligation of the portal vein was 8.9 + 1.6 mm Hg, with 26.6 + 5.4 mm Hg in the second measurement five weeks later (p < 0.05). No gastroesophageal varices or hypertensive portal gastropathy were seen at endoscopy procedures in our sample at any time in the study. Conclusion: Portal vein ligation in minipigs has been validated in the production of portal hypertension, but not in the formation of esophageal varices.

Uteropexy in sheep as potential method for prevention of uterine torsion

Background: Uterine torsion is one of many causes of dystocia in sheep. Failure in performing of wright-time diagnostic procedures and treatment by certain obstetric procedures, can result with death of both fetus and ewe. There is sufficient knowledge about risk factors which could contribute to the occurrence of uterine torsion in sheep, but there is insufficient knowledge about measures for prevention of uterine torsion. The aim of this study was to evaluate the effects of performing incorporative uteropexy as potential method for prevention of uterine torsion. Cases: This research was part of the experimental research of changes in the anterior presentation in sheep fetuses due to their ventro-sacral position in the 2nd half of gestation. At the same sheep farm where afore mentioned research was conducted, the farmer has reported the death of 3 pregnant ewes. In all of 3 animals, torsion of the uterus was diagnosed by patho-anatomical examination. This study was conducted on 6 ewes. All of the animals were in the period around the 100th day of pregnancy at the time of clinical examination. The exact day of pregnancy was not determinated because of free mating in the herd. Confirmation of pregnancy in all of 6 ewes was performed by ultrasound examination. Uniparous pregnancy was found in all of 6 ewes. The entire surgical procedures were performed in the field conditions. Laparotomy was performed in the animals positioned in the left lateral recumbency. Surgical procedure of incorporative uteropexy was performed during the closure of muscle layers of abdominal wall. In need for experimental research of changes in the anterior presentation in sheep fetuses due to their ventro-sacral position in the 2nd half of gestation, 14 days after surgical procedures were conducted, all of sheep were positioned by assistants into a sitting position so that their trunks were vertical to the ground and kept in that position for 2 min. Ultrasound examination of surgical place of uteropexy confirmed that, in all of animals, uteruses were in place of surgical procedures. All of 6 ewes included in this study lambed naturally. One of 6 sheep was sent for economic exploitation on the 14th day after lambing. At the slaughter line, the abdominal wall was evaluated at the site where the incorporative uteropexy was performed. Patho-anatomical examination revealed tissue adhesions at the junction of the uterine horn with the abdominal wall. Discussion: Postsurgical tissue adhesions develop during normal healing process of tissue. According to our knowledge, previous studies do not mention effective measures that could contribute to the prevention of uterine torsion in sheep, but attention is focused on prompt diagnosis and treatment of the disease. According to the results of this study, postsurgical tissue adhesions were developed and confirmed by patho-anatomical examination in 1 sheep. Other 5 sheep were not economically exploited or sacrificed, and no studies were performed to establish the presence of postsurgical tissue adhesions. In conclusion, it could be said that incorporative uteropexy could be considered as preventive procedure in order to avoid the development of uterine torsion in ewes which have shown a history of this pathology, but also in ewes with identified risk factors for the disease. In future studies, it is necessary to identify more parameters which will contribute to identification of sheep which have high risk factors to obtain the torsion of uterus. Also, it is necessary to use non-invasive methods of clinical diagnostics, primary ultrasound diagnostic, to evaluate the area of incorporative uteropexy in order to assess newly formed tissue adhesions as well as to assess the vitality of fetus. It is necessary to follow the lambing process of ewes with incorporated uterus, and to provide medical assistance to the animals if complications occur during the lambing time.

Experimental model for controlled endoscopic subepithelial vocal fold injury in rats

Purpose: To present a detailed, reproducible, cost-efficient surgical model for controlled subepithelial endoscopic vocal fold injury in the rat model. Methods: Six male Sprague Dawley rats were enrolled in the experiment. The left vocal folds were used to carry out the injury model, and the right vocal fold served as control. After deep sedation, the rats were placed on a custom operating platform. The vocal fold injury by subepithelial stripping was carried out using custom-made microsurgical instruments under endoscopic guidance. Data were analyzed for procedural time and post-procedural pain. Microcomputed tomography (micro-CT) scan and histologic images were obtained to assess the length, area, and depth of injury to the vocal fold. Results: The mean procedural time was 112 s. The mean control vocal fold length was 0.96 ± 0.04 mm. The mean vocal fold injury length was 0.53 ± 0.04 mm. The mean vocal fold surface was 0.18 ± 0.01 mm2 with a mean lesion area of 0.05 ± 0.00 mm2. Mean vocal fold injury depth was 375.4 ± 42.8 µm. The lesion length to vocal fold length ratio was 0.55 ± 0.03, as well as lesion area to vocal fold surface area was 0.29 ± 0.02. Conclusions: Our described experimental vocal fold injury model in rats is found to be fast, safe, cost-efficient, and reproducible with a rapid learning curve.

Hematological and biochemical parameters of premature kids of goats subjected to different dexamethasone protocols / Parâmetros hematológicos e bioquímicos de cabritos prematuros de cabras submetidas a diferentes protocolos de dexametasona

Corticosteroid therapy has been used for ruminants to allow lung maturation and the birth of premature babies. However, when considering laboratory analyses of these animals, very little data is available regarding hematological and biochemical patterns, especially for premature goats, and the effects of corticotherapy on these parameters are unknown. In this context, the objective of this study was to evaluate the hematological and biochemical parameters during the first hours of life of premature kids from goats subjected to different dexamethasone protocols. For this, the goats were divided into four groups: group I, goats that received 20 mg of dexamethasone at 139 days of gestation; group II, 2 mg of dexamethasone from the 133rd to 136th day of gestation, 4 mg from the 137th to 139th, and 20 mg on the 140th; group III, 16 mg of dexamethasone from the 139th day, with repeated doses every 12 h until elective surgery; and group IV, goats that received 4, 8, 16, and 20 mg of dexamethasone at 137, 138, 139, and 140 days of gestation, respectively. Blood samples were obtained at birth (T0h) and after 1 (T1h), 12 (T12h), 24 (T24h), and 48 h (T48h) of life for hemogram and serum biochemistry assessment of urea, creatinine, total protein (PT), and gamma-glutamyltransferase (GGT). PT levels and GGT activity were lower at birth in all groups and rose after colostrum ingestion. The creatinine values for all the experimental groups did not differ between T0h and T1h; however, they decreased in the subsequent moments. Except for group I, urea concentrations were higher at T48h than at T1h. The red blood cell, hemoglobin, hematocrit, and mean corpuscular hemoglobin counts decreased over time. The total leukocyte count behaved differently in different experimental groups, and was influenced by the levels of dexamethasone, mainly due to the change in the counts of segmented neutrophils and lymphocytes. It was concluded that significant changes in the hematological and biochemical parameters occur in the first hours of life of premature kids, and that the treatment of goats with dexamethasone can affect these parameters in a dose-dependent manner.

A corticoterapia tem sido empregada em ruminantes com o objetivo de permitir a maturação pulmonar e o nascimento de filhotes prematuros. Entretanto, ao se considerar análises laboratoriais desses animais, pouquíssimos dados estão disponíveis quanto aos padrões hematológicos e bioquímicos, especialmente em caprinos prematuros, e tampouco se sabe sobre os efeitos da corticoterapia sobre parâmetros hematológicos e bioquímicos nesses animais. Nesse contexto, objetivou-se avaliar os parâmetros hematológicos e bioquímicos das primeiras horas de vida de cabritos prematuros provenientes de cabras que utilizaram diferentes protocolos de dexametasona. Para tal, as cabras foram divididas em três grupos: grupo I, cabras que receberam 20 mg de dexametasona aos 139 dias de gestação; grupo II, 2 mg de dexametasona do 133° ao 136° dia de gestação, 4 mg do 137° ao 139° e 20 mg no 140° dia; grupo III, 16 mg de dexametasona a partir do 139° dia, com doses repetidas a cada 12 horas até a cirurgia eletiva; e grupo IV, cabras que receberam 4, 8, 16 e 20 mg de dexametasona no 137°, 138°, 139° e 140° dias de gestação, respectivamente. As amostras sanguíneas dos cabritos foram obtidas ao nascimento (T0h), 1 (T1h), 12 (T12h), 24 (T24h) e 48 horas (T48h) de vida para avaliação do hemograma e bioquímica sérica de ureia, creatinina, proteína total (PT) e gamaglutamiltransferase (GGT). Os teores de PT e atividade de GGT foram menores ao nascimento em todos os grupos, elevando-se após ingestão do colostro. Os valores de creatinina em todos os grupos experimentais não diferiram entre T0h e T1H, entretanto, diminuíram nos momentos subsequentes. Com exceção do grupo I, as concentrações de ureia foram maiores no T48h em comparação com o T1h. Os valores de hemácias, hemoglobina, hematócrito e volume corpuscular médio diminuíram ao longo do tempo, enquanto a concentração de hemoglobina corpuscular média aumentou ao longo do tempo. A contagem leucocitária total se comportou de maneira distinta nos diferentes grupos experimentais, demonstrado ser influenciada pelos teores de dexametasona principalmente em decorrência da alteração nas contagens de neutrófilos segmentados e linfócitos. Conclui-se que alterações significativas dos parâmetros hematológicos e bioquímicos ocorrem nas primeiras horas de vida de cabritos prematuros e o tratamento de cabras com dexametasona também pode afetar tais parâmetros de forma dependente da dose.

An experimental pleural drainage device in hypertensive pneumothorax

ABSTRACT Purpose To develop a specific device for pleural drainage in hypertensive pneumothorax. Methods The prototype was modeled from the free version of a 3D modeling application, printed on a 3D printer using ABS® plastic material, and tested in a pleural drainage simulator. Results Pleural drainage in the simulator using the prototype was feasible and reproducible. Conclusions While the prototype is functional in the simulator, it requires improvement and refinement for use in humans.

Comparison of the internal thoracic artery flow dissected by video endoscopy or conventional technique

ABSTRACT Purpose: To compare the blood flow in the internal thoracic artery when dissected endoscopically in a conventional manner, in addition to develop a reliable experimental training model for the surgical team. Methods: Paired experimental study. Ten pigs were operated and had both internal thoracic arteries dissected, the right with a conventional technique and the left by video endoscopy. The main outcomes to be studied were flow, length, and time of dissection of each vessel. Results: Blood flow measurements were performed with mean heart rate of 100 ± 16 bpm and mean arterial pressure of 89.7 ± 13 mm Hg. The mean blood flow of endoscopic dissection of the internal thoracic artery was 170.2 ± 66.3 mL/min and by direct view was 180.8 ± 70.5 (p = 0.26). Thus, there was no statistically significant difference between the flows, showing no inferiority between the methods. Conclusions: The minimally invasive dissection of the internal thoracic artery was shown to be not inferior to the dissection by open technique in relation to the blood flow in the present experimental model. In addition, the model that we replicated was shown to be adequate for the development of the learning curve and improvement of the endoscopic abilities.

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.

Thoracic aortic aneurysm. An experimental model in pigs

ABSTRACT Purpose To describe an unpublished experimental model of descending thoracic aortic aneurysm in pigs. Methods Ten Landrace female pigs aged 10 to 12 weeks old and with initial weights from 17 to 25 kg were anesthetized and their descending thoracic aortas exposed by fifth intercostal space left thoracotomy. The thoracic aorta was isolated. A 2-cm wide × 2-cm long patch of ready-made bovine pericardium was sewn onto the left anterolateral side of the aorta. After three weeks' follow-up, a control aortography was taken, and the animals were euthanized. The segment of thoracic aorta containing the aneurysm and the adherent tissues were explanted en bloc. The specimens were stained for histological examination. Results One hundred percent of the animals survived the procedure, and after sacrifice a patent aneurysm was observed in all of them. There were no defects on the suture lines. Weight gain during follow-up was normal. All specimens exhibited intense adventitial reaction with myofibroblasts. There were no complications related to the thoracotomy. Conclusions The descending thoracic aortic aneurysms induced experimentally appear to be stable, were of easy execution, with null mortality and no influence on the animals' normal development. Furthermore, they have similar characteristics to those observed in human degenerative aneurysms.

Integration of heterologous bone matrix associated with polymethylmethacrylate in induced tibial bone defects. An experimental study in rabbits

ABSTRACT Purpose To analyze and compare the reactions at the interface between the composite, composed of fragmented heterologous mineralized bone matrix (MOMHF) and polymethylmethacrylate (PMMA), and the rabbit's tibias, through macroscopic evaluation and scanning electron microscopy (SEM) in different periods. Methods In this study, 12 New Zealand adult rabbits were used (E1: n = 3, E2: n = 3, E3: n = 3 and E4: n = 3). They had the right tibial defects filled with composite and were evaluated immediately after surgery and at 30, 60, 90, and 120 days. Results The composites were incorporated and integrated into the recipient beds in 100% of the cases, defined by the MOMHF osseointegration and the PMMA fibrointegration, with no sign of infection, migration, or rejection. Conclusions The behavior of the composites in the recipient beds demonstrates that these biomaterials have the potential to be used in bone defect repairs, offering, thus, better quality of life to the orthopedic patient.

Skin graft associated with platelet-rich plasma in correcting extensive injuries resulting from the resection of skin cancer chemically induced in rats

ABSTRACT Purpose: To evaluate whether using platelet-rich plasma (PRP) in the graft recipient bed after the resection of a neoplasia can influence its recurrence because this product stimulates angiogenesis, mitogenesis and chemotaxis. Methods: A study with 30 rats Wistar (Rattus norvegicus albinus), which were separated into group A (induction of carcinogenesis, PRP in the postoperative period) and group B (induction of carcinogenesis, absence of PRP in the postoperative period), with 15 animals in each. Carcinogenesis was induced on the skin of the animals' chest by the topical application of 0.5% dimethylbenzantracene (DMBA) diluted in acetone. After surgical resection of the induced neoplasia, PRP was used to stimulate angiogenesis before surgical wound synthesis. Data on the control and experimental groups and macroscopic and microscopic variables were evaluated using analysis of variance and the Tukey's test (5%). Results: It was possible to determine that the use of PRP is good in reconstructive surgeries, but it is contraindicated in patients during tumor resection, as it can cause changes in the surgical bed, in addition to stimulating recurrences and metastases. Conclusions: PRP may interact with tumour cells that were in the recipient site of the surgical wound during the resection of a neoplasia, and a local recurrence process can be triggered by applying this product.

Ultrasound with laparoscopy for the diagnosis of abdominal disorders in cattle

ABSTRACT: This study aimed to evaluate laparoscopy with abdominal ultrasound exams to establish accurate diagnosis and prognosis. The experimental design was a prospective clinical study. Nine adult crossbred bovines suffering from abdominal disorders were admitted to the cattle clinic for clinical examinations. Abdominal ultrasound was carried out, and complete blood counts were performed. Subsequently, exploratory laparoscopy was performed. After surgery (exploratory laparoscopy on the right or left side), animals with a severe prognosis or untreatable clinical condition were euthanised and necropsied. During laparoscopy, circumscribed reticuloperitonitis could not be detected, nor could other abnormalities in the cranioventral region of the abdomen previously observed on ultrasound and confirmed during necropsy. However, alterations due to peritoneal damage, such as adhesions, were observed dorsally in addition to alterations in macroscopic aspects of the peritoneal fluid. Exploratory standing laparoscopy through the paralumbar fossae may constitute a supplementary procedure for diagnosing abdominal disorders in cattle, but it is not suitable in cases of diseases characterised by focal lesions concentrated in the cranioventral region of the abdomen. When associated with clinical, laboratory, and ultrasound examinations, this technique may improve the accurate diagnosis and prognosis of abdominal disorders in cattle.

RESUMO: Este estudo teve como objetivo avaliar a laparoscopia com exames de ultrassom abdominal para estabelecer um diagnóstico e prognóstico precisos. O desenho experimental foi um estudo clínico prospectivo. Nove bovinos adultos mestiços com distúrbios abdominais foram utilizados. Os bovinos admitidos na Clínica de Bovinos foram submetidos a exame clínico, adicionalmente foram realizadas hemograma e ultrassonografia abdominal. Posteriormente, foi realizada laparoscopia exploratória. Após a cirurgia (laparoscopia exploratória no lado direito ou esquerdo), nove animais com manifestações clínicas graves e intratáveis foram sacrificados e necropsiados. Durante a laparoscopia, não foi possível detectar reticuloperitonite circunscrita, bem como outras anormalidades na região crânio-ventral do abdome, previamente observadas na ultrassonografia e confirmadas durante a necropsia. No entanto, alterações devido a dano peritoneal, como aderências, foram observadas dorsalmente. É possível que a laparoscopia exploratória em apoio quadrupedal através da fossa paralombar constitua um procedimento complementar para o diagnóstico de distúrbios abdominais em bovinos, embora não seja adequado em casos de doenças caracterizadas por lesões focais concentradas na região cranioventral do abdome. Quando associada a exames clínicos, laboratoriais e de ultrassom, essa técnica pode melhorar o diagnóstico e prognóstico preciso dos distúrbios abdominais em bovinos.

Simulated training model in a low cost for laparoscopic inguinal hernioplasty

Purpose Develop a 3D model for the simulation of laparoscopic inguinal hernioplasty transabdominal preperitoneal (TAPP). Methods This is an experimental study, 18 participants were selected, divided into three groups, experimental (GE) surgeons in training, control (GC) experienced surgeons and Shaw (GS) nonexperienced surgeons. The simulation in the 3D model was carried out in 6 sessions fulfilling the 5 stages. Opening the peritoneum with the creation of the preperitoneal space; identification of important structures; hernia identification and reduction; placement and fixation of the mesh in Coopers ligament and closure of the peritoneum. Results In the 1st stage, the GE obtained an average of 1.25 ± 0.42 in the 1st session and 3.25 ± 0.62 in the 6th session (p = 0.05) and in the 5th stage 0.91 ± 0.29 in the first session. 1st session and 1.91 ± 0.29 in the 6th session (p = 0.001), with no significant difference between groups. The learning and skill curve in the SG represented 1.08 ± 0.29 1st and 3.50 ± 0.90 6th session (p = 0.001). Conclusions The creation of a systematization of training in simulation applied to the three-dimensional model enabled gain in laparoscopic skills and underpinned its theoretical and practical foundations.(AU)

Effects of flunixin meglumine, meloxicam, and firocoxib on the acute-phase proteins in horses following standing castration / Efeitos do flunixin meglumine, meloxicam e firocoxib na concentração de proteínas da fase aguda após em equinos após castração

Excessive infection and inflammation are the most common complications associated with castration. The objective of this study was to compare the efficacy of flunixin meglumine (FM), meloxicam (MX), or firocoxib (FX) for inflammation control after castration in horses using acute-phase proteins (APP) as markers of inflammation. Thirty healthy, unbroken, mixed-breed horses (body weight 358.62±45.57kg and age 4.99±2.63 years) were randomly (n=10 animals/group) allocated to receive one of three different post-castration anti-inflammatory medicines: Group 1 (FM 1.1mg/kg bwt, IV, s.i.d for 5 days); Group 2 (MX 0.6mg/kg bwt, IV, s.i.d for 5 days); and Group 3 (FX 0.1mg/kg bwt, IV, s.i.d for 5 days). All horses were castrated in standing position, using the open technique. Serum and peritoneal APP concentrations were measured by sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE) and determined before castration (0), and 3, 5, 24, 48, 72, 120 and 168 hours after castration. The results were submitted to analysis of variance using the SAS statistical program, and means were compared by the Student-Newman-Keuls test (p<0.05). Three animals from the MX group developed hyperthermia (with rectal temperatures of 39.8, 39.3 and 38.9°C on day 4, 5 and 6, respectively) and showed local clinical signs of inflammation (inguinal and excessive scrotal edema) and reluctance to walk, as well as a rigid gait of the hind limbs. The same complications were observed in one FX horse. No complications were observed among the FM animals. The castration resulted in significant changes in serum and peritoneal values of total proteins, ceruloplasmin (Cp), transferrin (Tf), albumin (Alb), haptoglobin (Hp) and α1-acid glycoprotein (Gp) in animals of all experimental groups. However, the animals of the MX and FX groups presented more intense acute phase response compared to the animals of the FM group. Changes in the APP were associated with the surgical trauma of castration, but the differences between groups were associated with the ability of the nonsteroidal anti-inflammatory drug to control the inflammation. In conclusion, and based on the findings of acute phase proteins, flunixin is more efficient to control the magnitude of inflammation following castration as compared to meloxicam and firocoxib.(AU)

Infecção e inflamação excessivas são as complicações mais comuns associadas à castração. O objetivo deste estudo foi comparar a eficácia do flunixin meglumine (FM), meloxicam (MX) ou firocoxib (FX) no controle da inflamação após a castração em cavalos usando proteínas da fase aguda (APP) como marcadores de inflamação. Trinta equinos saudáveis (358,62±45,57kg; 4,99±2,63 anos) foram em função dos anti-inflamatórios utilizados após as castrações aleatoriamente (n= 10 animais/grupo) alocados em três diferentes grupos: Grupo 1 (FM 1,1mg/kg de peso, IV, sid por 5 dias); Grupo 2 (MX 0,6mg/kg de peso, IV, s.i.d por 5 dias); e Grupo 3 (FX 0,1mg/kg de peso, IV, s.i.d por 5 dias). Todos os cavalos foram castrados em posição quadrupedal, utilizando a técnica aberta. As concentrações de APP sérica e peritoneal foram separadas por eletroforese em gel de poliacrilamida (PAGE) com dodecil-sulfato de sódio (SDS) e determinadas no momento 0 (antes da castração) e com 3, 5, 24, 48, 72, 120 e 168 horas após a castração. Os resultados foram submetidos à análise de variância pelo programa estatístico SAS e as médias foram comparadas pelo teste de Student-Newman-Keuls (p<0,05). Três animais do grupo MX desenvolveram hipertermia (com temperatura retal de 39,8, 39,3 e 38,9° C nos dias 4, 5 e 6, respectivamente) e mostraram sinais clínicos locais de inflamação (edema inguinal e escrotal excessivo) e relutância em andar, bem como marcha rígida dos membros posteriores. As mesmas complicações foram observadas em um cavalo do FX. Não foram observadas complicações entre os animais do FM. Independente do grupo, a castração resultou em alterações significativas nos valores séricos e peritoneais de proteínas totais, ceruloplasmina (Cp), transferrina (Tf), albumina (Alb), haptoglobina (Hp) e glicoproteína ácida α1 (Gp). No entanto, os animais dos grupos MX e FX apresentaram resposta de fase aguda mais intensa quando comparados aos animais do FM. Alterações na resposta de fase aguda deveram-se ao trauma cirúrgico da castração, mas as diferenças entre os grupos foram associadas à capacidade do anti-inflamatório em controlar a inflamação. Em conclusão, baseado da resposta de fase aguda, o flunixin em comparação com o meloxicam e o firocoxib é mais eficiente no controle da inflamação após a castração em equinos.(AU)

Effects of flunixin meglumine, meloxicam, and firocoxib on the acute-phase proteins in horses following standing castration / Efeitos do flunixin meglumine, meloxicam e firocoxib na concentração de proteínas da fase aguda após em equinos após castração

Excessive infection and inflammation are the most common complications associated with castration. The objective of this study was to compare the efficacy of flunixin meglumine (FM), meloxicam (MX), or firocoxib (FX) for inflammation control after castration in horses using acute-phase proteins (APP) as markers of inflammation. Thirty healthy, unbroken, mixed-breed horses (body weight 358.62±45.57kg and age 4.99±2.63 years) were randomly (n=10 animals/group) allocated to receive one of three different post-castration anti-inflammatory medicines: Group 1 (FM 1.1mg/kg bwt, IV, s.i.d for 5 days); Group 2 (MX 0.6mg/kg bwt, IV, s.i.d for 5 days); and Group 3 (FX 0.1mg/kg bwt, IV, s.i.d for 5 days). All horses were castrated in standing position, using the open technique. Serum and peritoneal APP concentrations were measured by sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE) and determined before castration (0), and 3, 5, 24, 48, 72, 120 and 168 hours after castration. The results were submitted to analysis of variance using the SAS statistical program, and means were compared by the Student-Newman-Keuls test (p<0.05). Three animals from the MX group developed hyperthermia (with rectal temperatures of 39.8, 39.3 and 38.9°C on day 4, 5 and 6, respectively) and showed local clinical signs of inflammation (inguinal and excessive scrotal edema) and reluctance to walk, as well as a rigid gait of the hind limbs. The same complications were observed in one FX horse. No complications were observed among the FM animals. The castration resulted in significant changes in serum and peritoneal values of total proteins, ceruloplasmin (Cp), transferrin (Tf), albumin (Alb), haptoglobin (Hp) and α1-acid glycoprotein (Gp) in animals of all experimental groups. However, the animals of the MX and FX groups presented more intense acute phase response compared to the animals of the FM group. Changes in the APP were associated with the surgical trauma of castration, but the differences between groups were associated with the ability of the nonsteroidal anti-inflammatory drug to control the inflammation. In conclusion, and based on the findings of acute phase proteins, flunixin is more efficient to control the magnitude of inflammation following castration as compared to meloxicam and firocoxib.(AU)

Infecção e inflamação excessivas são as complicações mais comuns associadas à castração. O objetivo deste estudo foi comparar a eficácia do flunixin meglumine (FM), meloxicam (MX) ou firocoxib (FX) no controle da inflamação após a castração em cavalos usando proteínas da fase aguda (APP) como marcadores de inflamação. Trinta equinos saudáveis (358,62±45,57kg; 4,99±2,63 anos) foram em função dos anti-inflamatórios utilizados após as castrações aleatoriamente (n= 10 animais/grupo) alocados em três diferentes grupos: Grupo 1 (FM 1,1mg/kg de peso, IV, sid por 5 dias); Grupo 2 (MX 0,6mg/kg de peso, IV, s.i.d por 5 dias); e Grupo 3 (FX 0,1mg/kg de peso, IV, s.i.d por 5 dias). Todos os cavalos foram castrados em posição quadrupedal, utilizando a técnica aberta. As concentrações de APP sérica e peritoneal foram separadas por eletroforese em gel de poliacrilamida (PAGE) com dodecil-sulfato de sódio (SDS) e determinadas no momento 0 (antes da castração) e com 3, 5, 24, 48, 72, 120 e 168 horas após a castração. Os resultados foram submetidos à análise de variância pelo programa estatístico SAS e as médias foram comparadas pelo teste de Student-Newman-Keuls (p<0,05). Três animais do grupo MX desenvolveram hipertermia (com temperatura retal de 39,8, 39,3 e 38,9° C nos dias 4, 5 e 6, respectivamente) e mostraram sinais clínicos locais de inflamação (edema inguinal e escrotal excessivo) e relutância em andar, bem como marcha rígida dos membros posteriores. As mesmas complicações foram observadas em um cavalo do FX. Não foram observadas complicações entre os animais do FM. Independente do grupo, a castração resultou em alterações significativas nos valores séricos e peritoneais de proteínas totais, ceruloplasmina (Cp), transferrina (Tf), albumina (Alb), haptoglobina (Hp) e glicoproteína ácida α1 (Gp). No entanto, os animais dos grupos MX e FX apresentaram resposta de fase aguda mais intensa quando comparados aos animais do FM. Alterações na resposta de fase aguda deveram-se ao trauma cirúrgico da castração, mas as diferenças entre os grupos foram associadas à capacidade do anti-inflamatório em controlar a inflamação. Em conclusão, baseado da resposta de fase aguda, o flunixin em comparação com o meloxicam e o firocoxib é mais eficiente no controle da inflamação após a castração em equinos.(AU)

Development and validation of a simulator for teaching minimally invasive thoracic surgery in Brazil

ABSTRACT Purpose To develop and validate a chest cavity simulator for teaching video-assited thoracic surgery (VATS). Methods The first phase of the study consisted of developing a chest cavity simulator. A quasi-experimental study was performed in the second phase, and 25 surgeons and residents participated in a three-stage pulmonary suture experiment. The videos were recorded and timed. Generalized linear regression models for repeated measures were used to analyze the outcome change over time. Results The chest cavity simulator consists of a console simulating the left hemithorax. Among the participants, 96% rated the design, visual aspect, positioning ergonomics, and triangulation of the portals as very good or excellent (face validity). There was a decrease in suturing time in step 1 from 435.7 ± 105 to 355.6 ± 76.8 seconds compared to step 3 (p = 0.001). The evaluation of the simulation effectiveness and performance (content validity) was rated as very good or excellent by 96% ofparticipants. The most experienced surgeon showed significant reduction in procedure time (p = 0.021) (construct validity). Conclusions The thoracic cavity simulator is realistic, showing content and construct validity, and can be used in VATS training. The simulation model allowed skill gain in the endoscopic suture.

Experimental study of amniotic membrane or topical propolis on induced cutaneous wound healing in Wistar rats / Estudo experimental do uso da membrana amniótica e da própolis tópica na cicatrização de feridas cutâneas induzidas em ratos Wistar

The study of propolis and the amniotic membrane as alternatives to promote the acceleration of healing has grown considerably. These products have shown to be easy to use, have bactericidal or bacteriostatic action and are affordable. The objective of the present study was to evaluate the action of the amniotic membrane of bitches and propolis in the healing of surgical wounds. To evaluate the efficacy of these methods the time for conclusion of the healing process of both groups was compared with a control group. In addition, the inflammatory response of each group was also evaluated to identify which alternative method could induce a better response in the healing process compared to the control group. For this purpose, 27 animals, Rattus norvegicus, variety Wistar, were used. Rats were separated into 3 groups with 9 animals each. Group I represented the 25% alcoholic propolis solution; Group II, Amniotic membrane; Group III was Control group. Wounds were assessed macroscopically for the lesion area, and microscopically for the histological quality of each wound layer and the intensity of inflammation and collagen deposition. After the macroscopic analysis, it was observed that there were no statistical differences among the 3 groups (p> 0.05) relevant to accelerate the healing process in terms of presence of inflammatory cells, fibroblasts, collagen, neovascularization, granulation tissue and re-epithelialization.

O estudo da própolis e da membrana amniótica como alternativa para promover a aceleração da cicatrização vem crescendo bastante, numa tentativa de buscar métodos alternativos para cicatrização de feridas que apresentem fácil utilização, ação bactericida ou bacteriostática e tenha custo acessível. Com o presente estudo objetivou-se avaliar a ação da membrana amniótica de cadelas e da própolis na cicatrização de feridas cirúrgicas, comparando o tempo no processo de cicatrização com o grupo controle e a resposta inflamatória de cada um, de maneira a identificar qual método alternativo induzirá melhor res-posta no processo de cicatrização em comparação ao grupo controle. Para tanto, foram utilizados 27 animais, Rattus norve-gicus, variedade Wistar, separados em três grupos com nove animais cada, sendo Grupo I – solução alcoólica de própolis a 25%; Grupo II – Membrana amniótica de cadelas; Grupo III – Grupo controle. As feridas foram avaliadas macroscopica-mente quanto à área da lesão, e microscopicamente quanto à qualidade histológica de cada leito da ferida e à intensidade de inflamação e deposição de colágeno. Após a análise macroscópica, constatou-se que não houve diferenças estatísticas (p>0,05) relevantes para acelerar o processo cicatricial, quanto a presença de células inflamatórias, fibroblastos, colágeno, neovasculari-zação, tecido de granulação e reepitelização, perante os tratamentos alternativos e o grupo controle no processo de cicatrização.

Experimental study of amniotic membrane or topical propolis on induced cutaneous wound healing in Wistar rats / Estudo experimental do uso da membrana amniótica e da própolis tópica na cicatrização de feridas cutâneas induzidas em ratos Wistar

The study of propolis and the amniotic membrane as alternatives to promote the acceleration of healing has grown considerably. These products have shown to be easy to use, have bactericidal or bacteriostatic action and are affordable. The objective of the present study was to evaluate the action of the amniotic membrane of bitches and propolis in the healing of surgical wounds. To evaluate the efficacy of these methods the time for conclusion of the healing process of both groups was compared with a control group. In addition, the inflammatory response of each group was also evaluated to identify which alternative method could induce a better response in the healing process compared to the control group. For this purpose, 27 animals, Rattus norvegicus, variety Wistar, were used. Rats were separated into 3 groups with 9 animals each. Group I represented the 25% alcoholic propolis solution; Group II, Amniotic membrane; Group III was Control group. Wounds were assessed macroscopically for the lesion area, and microscopically for the histological quality of each wound layer and the intensity of inflammation and collagen deposition. After the macroscopic analysis, it was observed that there were no statistical differences among the 3 groups (p> 0.05) relevant to accelerate the healing process in terms of presence of inflammatory cells, fibroblasts, collagen, neovascularization, granulation tissue and re-epithelialization.(AU)

O estudo da própolis e da membrana amniótica como alternativa para promover a aceleração da cicatrização vem crescendo bastante, numa tentativa de buscar métodos alternativos para cicatrização de feridas que apresentem fácil utilização, ação bactericida ou bacteriostática e tenha custo acessível. Com o presente estudo objetivou-se avaliar a ação da membrana amniótica de cadelas e da própolis na cicatrização de feridas cirúrgicas, comparando o tempo no processo de cicatrização com o grupo controle e a resposta inflamatória de cada um, de maneira a identificar qual método alternativo induzirá melhor res-posta no processo de cicatrização em comparação ao grupo controle. Para tanto, foram utilizados 27 animais, Rattus norve-gicus, variedade Wistar, separados em três grupos com nove animais cada, sendo Grupo I solução alcoólica de própolis a 25%; Grupo II Membrana amniótica de cadelas; Grupo III Grupo controle. As feridas foram avaliadas macroscopica-mente quanto à área da lesão, e microscopicamente quanto à qualidade histológica de cada leito da ferida e à intensidade de inflamação e deposição de colágeno. Após a análise macroscópica, constatou-se que não houve diferenças estatísticas (p>0,05) relevantes para acelerar o processo cicatricial, quanto a presença de células inflamatórias, fibroblastos, colágeno, neovasculari-zação, tecido de granulação e reepitelização, perante os tratamentos alternativos e o grupo controle no processo de cicatrização.(AU)