Neouretra com enxerto autógeno de segmento intestinal vascularizado em felino / Autogenous vascularized intestinal grafting for urethral reconstruction in feline

Background: Serious urethral damage or recurrent obstructions in felines require a urethrostomy to provide a return to and maintenance of urinary flow. In some cases, urethral reconstruction with complementary tissue is required. Grafting of autogenous vascularized intestinal segments is widely used in human medicine to promote the functional restoration of the urethra, but in veterinary medicine, its use is still incipient. Thus, the aim of this report was to analyze and describe the use of thein functional urethral repair in a feline diagnosed with a severe urethral rupture. Case: A castrated male cat presented with urethral obstruction. Emergency decompression cystocentesis was performed, and fluids and analgesics were administered. Catheterization and urohydropropulsion were attempted to relieve the obstruction, without success. An emergency perineal urethrostomy was indicated. After the procedure, the diagnosis (obstructive lower tract urinary disease) and the infeasibility of restoring urinary flow by conventional urethrostomy techniques were confirmed. We opted for a laparoscopic-assisted prepubic urethrostomy; the pre-prostatic urethra was transected, and its caudais end was brought through an abdominal incision cranially. However, urethral tension was noted after this maneuver was performed. Thus, we decided to use autogenous vascularized intestinal segment grafting for urethral reconstruction. A segment of the ileum was prepared for grafting, with preservation of irrigation and mesenteric innervation. A terminoterminal anastomosis was performed on the stumps of the remaining intestine, and the mesentery was sutured. The ileal graft was isolated and washed to remove...

Neouretra com enxerto autógeno de segmento intestinal vascularizado em felino / Autogenous vascularized intestinal grafting for urethral reconstruction in feline

Background: Serious urethral damage or recurrent obstructions in felines require a urethrostomy to provide a return to and maintenance of urinary flow. In some cases, urethral reconstruction with complementary tissue is required. Grafting of autogenous vascularized intestinal segments is widely used in human medicine to promote the functional restoration of the urethra, but in veterinary medicine, its use is still incipient. Thus, the aim of this report was to analyze and describe the use of thein functional urethral repair in a feline diagnosed with a severe urethral rupture. Case: A castrated male cat presented with urethral obstruction. Emergency decompression cystocentesis was performed, and fluids and analgesics were administered. Catheterization and urohydropropulsion were attempted to relieve the obstruction, without success. An emergency perineal urethrostomy was indicated. After the procedure, the diagnosis (obstructive lower tract urinary disease) and the infeasibility of restoring urinary flow by conventional urethrostomy techniques were confirmed. We opted for a laparoscopic-assisted prepubic urethrostomy; the pre-prostatic urethra was transected, and its caudais end was brought through an abdominal incision cranially. However, urethral tension was noted after this maneuver was performed. Thus, we decided to use autogenous vascularized intestinal segment grafting for urethral reconstruction. A segment of the ileum was prepared for grafting, with preservation of irrigation and mesenteric innervation. A terminoterminal anastomosis was performed on the stumps of the remaining intestine, and the mesentery was sutured. The ileal graft was isolated and washed to remove...(AU)

NEOURETRA COM ENXERTO AUTÓLOGO DE SEGMENTO INTESTINAL EM FELINO

FARIA, B. G. O. Neouretra com enxerto autólogo de segmento intestinal em felino. 2020. 54p. Tese (Doutora em Ciência Animal nos Trópicos) Escola de Medicina Veterinária e Zootecnia Universidade Federal da Bahia, 2020. A uretrostomia em felinos é indicada nos casos de danos uretrais graves ou obstruções recorrentes para assegurar o retorno e manutenção do fluxo urinário. Entretanto, alguns casos podem necessitar de reconstrução uretral com tecido complementar. O enxerto de segmento intestinal autólogo é largamente utilizado na medicina para proporcionar a restauração funcional uretral, porém na medicina veterinária seu emprego ainda é incipiente. Desta forma, buscou-se avaliar a exequibilidade e aplicabilidade do enxerto de segmento intestinal autólogo na reparação uretral funcional em 14 felinos portadores de estenose ou ruptura uretral resultante de complicações de tratamentos anteriores, oito portadores de estenose e seis de ruptura uretral. Para tal, utilizou-se de segmento de aproximadamente sete centímetros da porção final do íleo, com preservação da irrigação e inervação mesentérica, com posterior anastomose terminoterminal dos intestinos remanescentes. Em 12 animais a uretra pré-prostática foi seccionada e em dois a secção ocorreu no colo da vesícula urinária. Foi realizado anastomose da uretra ou do colo da vesícula urinária a extremidade aboral do enxerto. Ato contínuo, com a extremidade oral foi confeccionada ostomia na região pré-púbica. Manobras transoperatórias para obtenção e aplicação do enxerto mostraram-se exequíveis e adequadas para manutenção da vitalidade tecidual do segmento enxertado e restauração do fluxo urinário imediato. Foram feitas avaliações clínicas e ultrasonográficas pós-operatórias por período mínimo de um ano que comprovaram a eficácia da técnica de enxertia e a normalidade do fluxo urinário, sem sinais de rejeição e mínimas complicações. O enxerto autólogo de segmento intestinal se comportou como bom substituto uretral e possui valor terapêutico para casos de reconstrução uretral, particularmente quando outras técnicas cirúrgicas são inviáveis.

FARIA, B. G. O. Neouretra with autologous graft intestinal segment in a cat. 2020. 54p. Thesis (Doctor in Animal Science on Tropics) School of Veterinary Medicine and Zootechny Federal University of Bahia, 2020. Urethrostomy in cats is indicated in cases of severe urethral damage or recurrent obstructions, to ensure the return and maintenance of urinary flow. However, some cases may require urethral reconstruction with tissues from other regions. The autogenous graft of vascularized intestinal segment is widely used in medicine to provide functional urethral restoration, but in veterinary medicine, its use is still limited. Therefore, the present study aimed to evaluate the feasibility and applicability of the autogenous graft of vascularized intestinal segment in functional urethral repair of 14 cats with stenosis or urethral rupture caused by complication of previous treatment. Eight cats were presented with urethral stenosis and six with urethral rupture. A segment of approximately seven centimeters from the final portion of the ileum, with preservation of its irrigation and mesenteric innervation, and subsequent end-to-end anastomosis of remained intestines was used. In 12 animals, the pre-prostatic urethra was sectioned and in two animals section occurred in the urinary bladder neck. Anastomoses of the urethra or the urinary bladder neck to the aboral end of the graft was performed. Thereafter an ostomy was performed with the oral end in the prepubic region. Transoperative maneuvers for obtaining and applying the graft proved to be feasible and suitable for maintaining the tissue vitality of the grafted segment and restoring the immediate urinary flow. Postoperative clinical and ultrasonographic evaluations were performed for a minimum period of one year, which proved the effectiveness of the grafting technique and the normality of the urinary flow, with no signs of rejection and minimal complications. Thus, the autogenous graft of vascularized intestinal segment behaves as a good urethral substitute and has significant therapeutic value for cases of urethral reconstruction, particularly when other surgical techniques are not feasible.

Comparative evaluation of the effects of a new biological adhesive (Colagel) on the tensile strength and healing of intestinal anastomoses / Avaliação comparativa nos efeitos de um novo adesivo biológico (Colagel) sobre a resistência tênsil e a cicatrização de anastomoses intestinais

The effects of a new biological adhesive based on a mixture of gelatin-resorcin and formaldehyde (Colagel) for use as an adjuvant in the reinforcement, impermeabilization and healing of intestinal anastomoses were evaluated and compared to those obtained with omentun fixation, the standard procedure used for this purpose. Two ileal anastomoses were performed in each of 12 experimental dogs using an extramucosal technique and single plane sutures. One of the anastomoses in each animal was covered with adhesive and the other with omentun, in random order. The anastomosed intestinal segments were tested for tensile strength and analysed histopathologically 1, 3, 7, 14, 21 and 28 days after surgery. The tensile strength of the anastomoses treated by the two different procedures was statistically identical. Histopathology revealed normal healing evolution for both procedures on days 1, 3 and 7, and greater exudation in the adhesive group on days 14, 21 and 28 after surgery.

Os efeitos de un novo adesivo biológico a base de gelatina - resorcina e formaldefdo (Colagel), como adjuvante no reforço, impermeabilização e cicatrização de anastomoses intestinais,    foram avaliados e comparados com a omentopexia, procedimento padrão em cirurgias dessa natureza. Duas anastomoses ileais foram realizadas em 12 cães de experimentação empregando-se, como sutura, técnica em pontos simples separados extramucosos em plano único. Para a avaliação comparativa, estas receberam, respectivamente, o adesivo e a omentopexia. Os segmentos intestinais que receberam as anastomoses foram avaliados segundo a força tênsil e histopatologia aos 1, 3, 7, 14, 21 e 28 dias de pós-operatório. 0 estudo da força tênsil das anastomoses tratadas pelos procedimentos não mostrou diferenças estatisticamente significativas. A histopatologia revelou evolução normal da cicatrização em ambas as técnicas, nos dias 1, 3 e 7 e maior exudação no grupo cota aos 14, 21 e 28 dias de pós-operatório.

Comparative evaluation of the effects of a new biological adhesive (Colagel) on the tensile strength and healing of intestinal anastomoses / Avaliação comparativa nos efeitos de um novo adesivo biológico (Colagel) sobre a resistência tênsil e a cicatrização de anastomoses intestinais

The effects of a new biological adhesive based on a mixture of gelatin-resorcin and formaldehyde (Colagel) for use as an adjuvant in the reinforcement, impermeabilization and healing of intestinal anastomoses were evaluated and compared to those obtained with omentun fixation, the standard procedure used for this purpose. Two ileal anastomoses were performed in each of 12 experimental dogs using an extramucosal technique and single plane sutures. One of the anastomoses in each animal was covered with adhesive and the other with omentun, in random order. The anastomosed intestinal segments were tested for tensile strength and analysed histopathologically 1, 3, 7, 14, 21 and 28 days after surgery. The tensile strength of the anastomoses treated by the two different procedures was statistically identical. Histopathology revealed normal healing evolution for both procedures on days 1, 3 and 7, and greater exudation in the adhesive group on days 14, 21 and 28 after surgery.

Os efeitos de un novo adesivo biológico a base de gelatina - resorcina e formaldefdo (Colagel), como adjuvante no reforço, impermeabilização e cicatrização de anastomoses intestinais,    foram avaliados e comparados com a omentopexia, procedimento padrão em cirurgias dessa natureza. Duas anastomoses ileais foram realizadas em 12 cães de experimentação empregando-se, como sutura, técnica em pontos simples separados extramucosos em plano único. Para a avaliação comparativa, estas receberam, respectivamente, o adesivo e a omentopexia. Os segmentos intestinais que receberam as anastomoses foram avaliados segundo a força tênsil e histopatologia aos 1, 3, 7, 14, 21 e 28 dias de pós-operatório. 0 estudo da força tênsil das anastomoses tratadas pelos procedimentos não mostrou diferenças estatisticamente significativas. A histopatologia revelou evolução normal da cicatrização em ambas as técnicas, nos dias 1, 3 e 7 e maior exudação no grupo cota aos 14, 21 e 28 dias de pós-operatório.