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Purpose: To compare robotic versus laparoscopic colectomies in colon cancer patients in general complications. Methods: Nine databases were searched for randomized controlled trials (RCT) investigating patients with colon cancer, submitted to robotic surgery (RS) compared to a laparoscopic (LC) approach. The risk of bias was assessed using RoB 2.0 tool, and certainty of the evidence was evaluated by Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Data synthesis was performed using the software R. The meta-analysis of the included studies was carried out using the fixed-effects model (DerSimonian and Laird). Heterogeneity was measured using I2 analysis. Results: A total of four studies were used with 293 patients. Three studies were used in this comparative LC vs. RS when evaluating infection rates on surgical wound sites. The odds ratio (OR) appeared to be slightly favorable to LC (OR = 3.05; 95% confidence interval-95%CI 0.78-11.96). In the hospitalization rates analysis, two randomized controlled trials were used, and the mean differences slightly favored the RS (MD = -0.54; 95%CI -2.28-1.19). GRADE evaluation detected a serious risk of bias due to RCT format and RoB-2 concurred. Conclusion: Both types of procedures seem to have their own benefits, risks, and limitations. They seem close to equal in terms of postsurgical infection and hospitalization.

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Purpose: To evaluate the gender distribution of first and last authors with Brazilian surgical affiliations in PubMed-indexed surgical journals. Methods: Data from eligible surgical journals were retrieved using Scimago Journal & Country Rank 2021 and manually reviewed. Manuscripts published from 2018 to 2022 were included if at least one author was affiliated with a Brazilian institution and a surgical specialty. Results: Data from 340 eligible surgical journals were included. We analyzed first and last authors' forenames of 1,881 manuscripts. Women comprised 16.7% of the first and 12.4% of the last authors. Analyzing the differences in gender trends in authorship across the five Brazilian regions, we found that the South had the highest representation, while the Midwest and North showed the lowest, respectively. Obstetrics and gynecology featured the highest percentage of women-first authors, whereas orthopedics had the lowest. For the last authorship, pediatric surgery showed the highest, with hand surgery having the lowest representation. Male first authors were 1.9 times more likely to engage in international collaborations. Conclusions: This study suggests the persistent underrepresentation of Brazilian women in surgical journal authorship. Local policy changes should be considered to encourage greater diversity and inclusivity in surgical research.

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Purpose: Illicit cosmetic injections remain highly prevalent and can cause serious complications, including death. We aimed to explore existing literature regarding the use of illicit cosmetic injections globally. Methods: We searched six databases with no language restriction from inception to 2022. We included all articles focused on adult patients of any gender who received any illicit cosmetic injection. Screening and data extraction followed standards from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews guidelines. Results: After screening 629 abstracts and 193 full texts, 142 citations were included. We identified articles from 28 countries and three multi-country studies. Most were from high-income (75.3%) and upper-middle-income countries (21.8%). Of all patients whose gender identity was described, 49.9% were transgender women, and 40.8% were cisgender women. The anatomic regions most frequently injected were the buttocks (35%) and the breast (13.3%). The most frequently described complications were granuloma (41.5%), dermatological problems (41.5%), infection (35.9%), and pulmonary complications (34.5%). Conclusions: We observed the impact of illicit silicone injections, particularly on cisgender women and transgender individuals. Existing barriers must be addressed, including healthcare prejudice and inadequate knowledge about care for gender minorities. This will require educating at-risk groups and enhancing policies to regulate these procedures.

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Purpose: To analyze the average time between submission and acceptance of national journals in seven Brazilian surgery journals from 2017 to 2022. Methods: It consists of a cross-sectional and observational study with a quantitative approach to analyze the acceptance time of articles approved by Brazilian journals on general surgery and its subspecialties, including Acta Cirúrgica Brasileira, Jornal Vascular Brasileiro, Arquivos Brasileiros de Cirurgia de Digestiva, Revista do Colégio Brasileiro de Cirurgiões, Journal of Coloproctology, Revista Brasileira de Cirurgia Plástica, and International Brazilian Journal of Urology. Results: The journals with the lowest average waiting times were Revista do Colégio Brasileiro de Cirurgiões, Acta Cirúrgica Brasileira, and Journal of Coloproctology, respectively, and, with the lowest interquartile range there is Acta Cirúrgica Brasileira. There was no significant difference between the pre-pandemic and pandemic periods. The study designs with the highest and lowest means were, respectively, ideas and innovations - also with the highest interquartile range - and expert opinion, while with the lowest interquartile range was technical skill. Conclusions: The acceptance time for articles in Brazilian surgery journals is extremely variable. Identifying these discrepancies highlights the importance of understanding editorial processes and seeking ways to improve consistency and efficiency in reviewing articles.

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Purpose: To compare the indicators, postoperative pneumoretroperitoneum-related complications, and postoperative recovery of laparoscopic preperitoneal inguinal hernia repair under different CO2 pneumoperitoneum pressures. Methods: The total of 187 adult patients with primary inguinal hernia who successfully underwent transabdominal preperitoneal prosthesis (TAPP) from September 2021 to September 2023 in the Department of General Surgery, Haimen People's Hospital affiliated to Nantong University, were collected. These patients were randomly divided into low abdominal pressure group (group A: pneumoperitoneum pressure = 8 mmHg), sub-low abdominal pressure group (group B: pneumoperitoneum pressure = 10 mmHg), moderate abdominal pressure group (group C: pneumoperitoneum pressure = 12 mmHg), and standard pressure group (group D: pneumoperitoneum pressure = 14 mmHg), with 40 patients each. Results: The operation time in group C (43.90 ± 9.75) was significantly lower than group A (51.98 ± 12.65, p 0.001), group B (46.70 ± 10.59, p 0.001), and was higher than that in group D without significant statistical differences (38.15 ± 7.98, P = 0.05). The peritoneal suturing time in group C (5.03 ± 1.07) was significantly higher than group A (4.23 ± 0.70, p 0.001), group B (4.55 ± 0.85, p = 0.03), and was significantly lower than that in group D (6.95 ± 1.96, p 0.001). Conclusion: Selecting sub-low abdominal pressure (12 mmHg) can help to have a shorter operation time, with less blood loss, and it did not add pneumoretroperitoneum-related complications. Changing the pneumoperitonium pressure during different phases of the surgery is also an optimal option.

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Purpose: To investigate the profile of hospital admissions for sympathectomies performed in the Brazilian Unified Health System (SUS), comparing open and video-assisted techniques. Methods: Data on sympathectomies were collected from the SUS Department of Informatics (DATASUS), recorded between 2014 and 2023. The data were tabulated, and descriptive statistics and correlation analyses were performed. Results: There was reduction in the number of admissions for all sympathectomies during the analyzed period. The use of video-assisted surgeries was higher than that of open surgeries for thoracic procedures, but lower for lumbar procedures. The costs of hospital admission for the procedures were similar, although the length of stay and mortality associated with open surgeries were higher, both in thoracic and lumbar sympathectomies. Conclusions: The collected data were not individualized, preventing follow-up. Additionally, the study did not account for procedures performed in the private healthcare system. Despite its limitations, this study provides an overview of sympathectomies in Brazil, indicating that, although open sympathectomies are potentially more disadvantageous, they are still widely performed, especially for lumbar procedures.

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Purpose: To develop and validate a trans oral endoscopic thyroidectomy vestibular approach (TOETVA) simulator. Methods: The first phase of the project consisted of designing and developing a transoral thyroid surgery simulator based on real surgeries. The product has the oral cavity for attaching the three trocars and the cervical part containing the thyroid and adjacent structures. In the second phase, the simulator was validated by specialists who performed an endoscopic thyroidectomy procedure. They all filled a questionnaire about the simulator and the simulation based on the Likert scale. Results: The simulator consists of a console similar to a human bust and a high-resolution camera system connected to a 22-inch monitor. The simulator had excellent results in the visual evaluation (face validity), with 100% of responses between good and excellent for the following characteristics: synthetic structures, design, visibility of the surgery field, resistance, resilience, fulcrum effect, ergonomics, surgical material, and practicality. The last three were rated higher, with more votes for excellent. For content validity, the items that received the best ratings were, precisely, the steps relating to the surgical procedure: opening the intermuscular midline, isthmotomy, and thyroidectomy. Conclusions: The thyroidectomy training box showed great ability to simulate a TOETVA, with satisfactory evaluations concerning its visual and content validation.

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ABSTRACT Purpose: This study aimed to evaluate a new therapeutic option for the spasticity using ultrasound neuromodulation in an animal model of spastic cerebral palsy. Methods: Thirty-two adult male Wistar rats were randomly distributed in: negative control (NC); positive control (PC); untreated model (UTM); and treated model (TM). Rats in the control groups received sham surgery, and rats in the model groups received the spastic cerebral palsy model surgery. The rats' motor functions were evaluated by the Rotarod and CatWalk tests before and after surgery. PC and TM groups underwent ultrasonic neuromodulation by a physiotherapeutic ultrasound (intensity 0.1 W/cm2, at 1 MHz) continuous mode for 5 seconds, for seven days. Results: Twelve rats showed a spastic pattern (UTM = 6 and TM = 6), motor limitations (UTM = 6 and TM = 6), and ten had difficulty feeding (UTM = 5 and TM = 5). One UTM group rat could not recover its preoperative latency time, while the other rats in the model groups did. The speed at which the limbs swung reduced after surgery and increased in subsequent assessments, demonstrating greater instability and a deficit in locomotion balance. Conclusions: Results were not yet sufficient to assert ultrasound neuromodulation as a possible therapy for spasticity in spastic cerebral palsy in the parameters used, and more studies are necessary.

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Purpose: Full-endoscopic spine surgery (FESS) is associated with specific complications, possibly linked to increased intracranial pressure (ICP) resulting from continuous saline infusion into the epidural space. This study aimed to assess the impact of saline irrigation and its correlation with noninvasively obtained ICP waveform changes. Methods: Patients undergoing FESS between January 2019 and November 2020 were included. Noninvasive ICP (n-ICP) monitoring utilized an extracranial strain sensor generating ICP waveforms, from which parameters P2/P1 ratio and time to peak (TTP) values were derived and correlated to irrigation and vital parameters. Documentation occurred at specific surgical intervals (M0-preoperatively; M1 to M4-intraoperatively; M5-postoperatively). Mixed-model analysis of variance and multiple comparisons tests were applied, with M0 as the baseline. Results: Among 31 enrolled patients, three experienced headaches unrelated to increased ICP at M5. The P2/P1 ratio and TTP decreased during surgery (p < 0.001 and p < 0.004, respectively). Compared to baseline, P2/P1 ratio and vital parameters remained significantly lower at M5. No significant differences were observed for fluid parameters throughout surgery. Conclusions: This study demonstrated a decline in the n-ICP parameters after anesthetic induction despite the anticipated increase in ICP due to constant epidural irrigation. The n-ICP parameters behaved independently of fluid parameters, suggesting a potential protective effect of anesthesia.

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The aim of this study was to evaluate two liver biopsy techniques by transrectal Natural Orifice Transluminal Endoscopic Surgery (NOTES) and compare tensiometric parameters of rectal sealing using 2-octyl cyanoacrylate glue or conventional rectal sutures in a dog cadaver model. In sixteen dog cadavers two liver biopsy techniques were performed via transrectal NOTES using either polypectomy diathermy forceps or endoscopic oval biopsy forceps. The cadavers were divided into two groups: Glue Group (GG) where rectal sealing was performed with 2-octyl cyanoacrylate glue and Suture Group (SG) with the rectal defect sealed with simple continuous extracorporeal 3-0 polydioxanone sutures. The rupture pressure of the seals was measured on a rectal burst test. The diathermy polypectomy endoscopic forceps biopsy technique was significantly faster (p<0.001) and provided larger diameter samples. Rectal sealing was significantly faster (p<0.001) in the GG. There was no difference between the two groups with regard to rupture pressure (258.5 mmHg) with air insufflation. Using endoscopic oval biopsy forceps, biopsy samples can only be collected from the surface of the liver, whereas polypectomy forceps with a diathermy loop can be used to collect samples from the tip of the hepatic lobe. There was no difference in rectal rupture pressure in the burst test between the cadavers where sealing was performed with rectal sutures and those where cyanoacrylate adhesive was used.(AU)

O objetivo do presente estudo foi avaliar duas técnicas de biopsia hepática realizadas por cirurgia endoscópica transluminal por orifícios naturais (NOTES) transretal e parâmetros tensiométricos do selamento retal usando adesivo de 2-octil cianoacrilato ou sutura retal convencional em cadáveres de cães. Em 16 cadáveres de cães, foram realizadas duas técnicas de biopsias hepáticas usando pinça diatérmica de polipectomia e pinça de biopsia oval. Os cadáveres foram divididos em dois grupos: sendo que o Glue Group (GG) recebeu o adesivo de 2-octil cianoacrilato para selamento retal e o Suture Group (SG), recebeu sutura contínua simples extracorpórea com fio polidioxanona 3-0. A pressão de ruptura retal foi mensurada por meio do teste de pressão intra-retal. A técnica de biopsia hepática com pinça diatérmica de polipectomia foi mais rápida (p<0.001) e providenciou amostras maiores. O selamento retal foi mais rápido no GG (p<0.001). Não houve diferença entre os grupos com relação a pressão de ruptura retal com insuflação de ar (258.5 mmHg). A biopsia hepática com pinça oval é limitada a colheita de fragmentos superficiais do fígado, já a pinça de polipectomia permite a colheita de fragmentos nas extremidades. Os parâmetros tensiométricos do reto, avaliados por meio do teste da pressão de ruptura retal foram semelhantes tanto em cães que receberam sutura retal quanto nos que receberam apenas o adesivo de 2-octilcianocrilato em cadaveres de cães.(AU)

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ABSTRACT Bariatric surgery induces a variety of changes, including changes in the composition of the gut microbiota. The investigation evaluated the effect of the experimental gastrojejunal bypass bariatric surgery hourglass (EBSSC G-YB) on the fecal bacterial microbiota in obese Landrace pigs. Twelve six-month-old animals were used, which were supplemented with energy from 2.5 months for a period of 120 days, enough time to reach the condition. Subsequently, they were intervened with the EBSSC G-YB and the changes in the microbiota were characterized, comparing an experimental group with two control groups in a period of 30 days. The result was that the microbiota of the three groups showed Proteobacteria, Firmicutes and Bacteroidetes as the ones with the highest relative abundance, however, at the end of the experiment a difference is highlighted, where the Phylum Spirochaetes was constant and more frequently in the experimental group, while for control groups 1 and 2 it was the Phylum Tenericutes. Although the differences were not significant, qualitatively there was greater diversity in the experimental group, with greater abundance of Escherichia-Shigella and Pseudohongiella, which may be useful as quantifiable biomarkers of weight loss in future research.

RESUMO A cirurgia bariátrica induz uma variedade de alterações, incluindo alterações na composição da microbiota intestinal. A investigação avaliou o efeito da cirurgia bariátrica experimental relógio de areia com bypass gastrojejunal (EBSSC G-YB) na microbiota bacteriana fecal em porcos Landrace obesos. Foram utilizados 12 animais, com seis meses de idade, os quais foram suplementados com energia a partir de 2,5 meses, por um período de 120 dias, tempo suficiente para atingir a condição. Posteriormente, foi realizada intervenção com o EBSSC G-YB e avaliadas as alterações na microbiota, comparando-se um grupo experimental com dois grupos controle, em um período de 30 dias. O resultado foi que a microbiota dos três grupos apresentou Proteobacteria, Firmicutes e Bacteroidetes como as de maior abundância relativa, porém, ao final do experimento, destaca-se uma diferença, em que o filo Spirochaetes foi constante e com maior frequência no grupo experimental, enquanto para os grupos controle 1 e 2, foi o filo Tenericutes. Embora as diferenças não tenham sido significativas, qualitativamente houve maior diversidade no grupo experimental com maior abundância de Escherichia-Shigella e Pseudohongiella, o que pode ser útil como biomarcadores quantificáveis ​​de perda de peso em pesquisas futuras.

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Purpose: To explore artificial intelligence's impact on surgical education, highlighting its advantages and challenges. Methods: A comprehensive search across databases such as PubMed, Scopus, Scientific Electronic Library Online (SciELO), Embase, Web of Science, and Google Scholar was conducted to compile relevant studies. Results: Artificial intelligence offers several advantages in surgical training. It enables highly realistic simulation environments for the safe practice of complex procedures. Artificial intelligence provides personalized real-time feedback, improving trainees' skills. It efficiently processes clinical data, enhancing diagnostics and surgical planning. Artificial intelligence-assisted surgeries promise precision and minimally invasive procedures. Challenges include data security, resistance to artificial intelligence adoption, and ethical considerations. Conclusions: Stricter policies and regulatory compliance are needed for data privacy. Addressing surgeons' and educators' reluctance to embrace artificial intelligence is crucial. Integrating artificial intelligence into curricula and providing ongoing training are vital. Ethical, bioethical, and legal aspects surrounding artificial intelligence demand attention. Establishing clear ethical guidelines, ensuring transparency, and implementing supervision and accountability are essential. As artificial intelligence evolves in surgical training, research and development remain crucial. Future studies should explore artificial intelligence-driven personalized training and monitor ethical and legal regulations. In summary, artificial intelligence is shaping the future of general surgeons, offering advanced simulations, personalized feedback, and improved patient care. However, addressing data security, adoption resistance, and ethical concerns is vital. Adapting curricula and providing continuous training are essential to maximize artificial intelligence's potential, promoting ethical and safe surgery.

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A dermoid is the presence of normal skin in an abnormal place. A mixed-breed, male, 4-month-old cat was presented with a history of ocular discomfort in the right eye. Ophthalmic examination on the right eye revealed lacrimation, blepharospasm, ocular discomfort and mild conjunctival hyperaemia. A mass with hair with a diameter of 5 mm on the temporal part of the bulbar conjunctiva was observed. Surgical excision of the mass was recommended. Histopathology of the excised tissue confirmed the diagnosis of a dermoid. There was no evidence of lesion recurrence 12 months after surgery. In the present case, complete surgical excision of the dermoid was curative. Although rare, dermoid should be included in the differential diagnosis of conjunctival disorders in cats.

Dermoide é a presença de pele normal em local inadequado. Um gato, sem raça definida, macho, com quatro meses de idade, apresentou histórico de desconforto ocular no olho direito. O exame oftálmico do olho direito revelou lacrimejamento, blefarospasmo, desconforto ocular e hiperemia conjuntival. Observou-se uma massa com pelos de 5mm de diâmetro na parte temporal da conjuntiva bulbar. A excisão cirúrgica da massa foi recomendada. A histopatologia do tecido excisado confirmou o diagnóstico de dermoide. Não houve recidiva da lesão 12 meses após a cirurgia. No presente caso, a excisão cirúrgica completa do dermoide foi curativa. Embora raros, os dermoides devem ser incluídos no diagnóstico diferencial de afecções conjuntivais em gatos.

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Purpose: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of gallbladder (GB) disease in small animals. The aims of this study were to investigate and compare the effect of different types of dissectors during LC in rabbits; electrothermal bipolar vessel sealing device (EBVS-LigaSure) and standard electrosurgical dissection (bipolar Maryland) for dissection of the GB in LC, correlating liver function tests (LFTs) in pre and postoperative periods (days 0, 3, 7, 15); macroscopic checking 15 days after surgery through necropsy; histopathological, bacteriological through bacterial growth by culture and intraoperative complications. Methods: Twenty rabbits were used, group (n = 10) using EBVS for GB dissection and cystic duct seal (GLL), and group (n = 10) using bipolar dissecting forceps and EVBS for cystic duct seal (GLE). Results: A higher concentration of alkaline phosphatase was observed on GLL 15 days after surgery when compared to GLE. In addition, GLE resulted in a higher concentration of alanine aminotransferase at three days when compared to GLL. Conclusion: In LC no significant statistical differences were found between EBVS and bipolar Maryland; both devices are equally safe and effective in LC. Further studies are required to evaluate the effectiveness of these devices in animals with gallbladder pathologies. Therefore, clinical studies are necessary.

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Background: Morphophysiology makes it possible to understand the entire organism of an animal, enabling the identification of abnormalities and alterations. In view of this, it is extremely important to understand the gastrointestinal system and the nutrition of companion animals, particularly dogs, as they tend to ingest inedible objects, which can result in changes in behavior and nutrition. The foreign body refers to objects that are resistant to digestion by hydrochloric acids, such as thread, stones, plastic, and bones. When animals are affected, they may show several symptoms such as vomiting, gastric distention, and intestinal obstruction. In addition, depending on the region and severity, surgical intervention may be required to remove the foreign body. The aim of this study was to describe a case of gastrointestinal obstruction in a bitch, as well as to address the established drug therapy and describe the surgical technique. Case: A 1-year-and-1-month-old Shih-Tzu bitch, weighing 5.6 kg, was initially treated at a veterinary clinic in Imperatriz, Maranhão. The bitch presented with lethargy and intermittent vomiting. On physical examination, ocular secretion and pain on abdominal palpation were observed, but the other parameters were within the normal range. Several tests were performed. In addition, the complete blood count showed alteration, indicating leukocytosis due to neutrophilia, together with monocytosis and eosinophilia. However, the biochemistry results were within normal limits, and the 4dx rapid test did not indicate any parasitic disease. Abdominal ultrasonography was decisive in confirming the diagnosis of a foreign body. The patient was referred to another veterinary clinic to undergo gastrostomy and enterotomy surgeries for the removal of foreign bodies. Moments before the surgery, due to the animal's worsening condition with emesis, the surgery had to be initially interrupted. Afterwards, it was sent to the surgical center, where it underwent gastrostomy and enterotomy proce-dures to remove 3 round structures. In the postoperative period, he was followed up to monitor the parameters, with cases of hypoglycemia that were effectively managed through appropriate interventions. In the following days until the day of discharge, he showed significant improvement, returning 10 days later to the clinic to remove the stitches. Discussion: The habit of consuming foreign objects is common among small animals but tends to affect younger dogs, like the patient in this case. According to the literature, foreign body obstruction can generate different clinical signs according to the affected region. In this case, the dog only presented pain on palpation in the abdomen region, along with gastrointestinal distress. The treatment indicated for this case was surgical intervention, specifically gastrostomy and enterotomy procedures. The ultrasound examination played a crucial role in confirming the diagnosis by identifying abnormal structures present in the stomach and small intestine. Complementary tests were performed to complete the physical examination. During hospitalization to treat the clinical conditions of emesis, the drug therapy of choice was Omeprazole and Maropitant Citrate, and Buscofen (dipyrone and scopolamine). The animal showed improvement during the postoperative period and the monitoring of the clinical parameters allowed for better control of its condition.

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Purpose: To evaluate patient characteristics and factors associated with surgical resection in patients with Crohn's disease (CD). Methods: An analysis was performed on data from 295 patients with CD in follow-up from 2001 to 2018. Medical record data comprised age, gender, location, behavior and duration of the CD, smoking, and extraintestinal manifestation. Patients were divided into two groups according to the presence or absence of surgical resection. Results: Out of the 295 patients with CD, 155 underwent surgical resection (53.2% male, mean age: 43.88 ± 14.35 years). The main indications for surgery were stenosis (44.5%), clinical intractability (15.5%), and intra-abdominal fistulas (15.5%). Smoking (p < 0.001), longer CD duration (p < 0.0001), ileo-colonic location (p = 0.003), stenosing behavior (p < 0.0001), and fistulizing behavior (p < 0.0001) were significantly associated with surgical resection. Initial use of biological was significantly more frequent in the group of patients without surgical resection (p < 0.001). Conclusions: Patients with CD still frequently need surgical treatment. Smoking (current or past), longer disease time, stenosing and fistulizing behavior, and ileo-colonic localization in CD patients were associated with a higher risk of surgery. Awareness about factors associated with unfavorable outcome allows such patients to be treated more appropriately.

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Purpose: The purpose of this study is to assess whether the Dunning-Kruger effect occurs in surgical residents when performing laparoscopic cholecystectomy in a porcine model. Methods: Prospective blinded study, which counted with forty PGY-1 general surgery residents who agreed to participate in the study were blindly recruited to perform a laparoscopic cholecystectomy in a porcine model. At the end of the procedure, the participants assigned a score of 0-10 for their own performance and the video of the operation was independently assessed by 2 experienced laparoscopic surgeons using a validated tool. Results: Participants were divided into groups of 10 individuals according to objective performance and compared. The group with the worst objective result was inferior to the group with the best objective result (3.77 ± 0.44 vs. 8.1 ± 0.44, p < 0.001), but they were similar in self-perception of performance (5.11 ± 1.69 vs. 6.1 ± 1.79, p = 0.999). Conclusions: In the studied sample, it was possible to demonstrate the presence of the Dunning-Kruger effect.

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Background: Urethropreputial fistulas are communicative conduits between the urethra, prepuce, and environment whose origin deviates the urinary flow from its physiological path. The condition has a multifactorial cause and is considered uncommon in dogs. By the scarce occurrence of this malformation, as well as the scarcity of case reports on the subject, the present work aims to report a case of congenital urethropreputial fistula in a mixed breed dog and the surgical procedures performed to correct this genitourinary abnormality. In addition, it seeks to cross information available in the literature with the changes found during the case attendance. Case: An approximately 1-year-old male canine, mixed breed, was attended at the Veterinary Hospital of the Federal Rural University of Pernambuco (HOVET - UFRPE) with a complaint of dysuria, where the urinary flow occurred by dripping through an orifice caudal to the external urethral ostium. According to the tutor, the animal presented the condition since its adoption at 2 months old. The general physical examination did not show any changes in the physiological parameters. The mucous membranes were normal in color, the capillary refill time was 2 s, there was no pain or discomfort on superficial and deep palpation of the abdomen, and the heart and respiratory rates were within the range considered normal for the species. The specific examination found the existence of a fistula on the ventral aspect of the foreskin, whose resolution required a surgical intervention that consisted of obliteration of the fistula communication channel by suturing the defect using an absorbable suture thread. However, this was not effective in solving the problem of the animal, which returned to the hospital complaining of ischuria, leading to the need for 2 other surgical procedures: A scrotal urethrostomy, whose result was also inadequate due to the displacement of the urethral catheter given the postoperative conditions and the animal's temperament, and, to guarantee the proper functioning of the lower urinary tract, avoiding recurrences, a new urethrostomy dorsal to the first, in the perineal region, was performed. The animal did not present episodes of urinary retention after the third procedure and had a significant improvement in the condition in which it was before the initial treatment. Discussion: Urogenital anomalies are rare in dogs and can be acquired or congenital. With an etiology still not fully elucidated, the variety of fistula presentations indicates that the condition probably has multifactorial causes. The affection may be confused with hypospadias. However, in this case, the external urethral ostium is out of its anatomical location, and several other abnormalities are present, like cryptorchidism, intersexuality, and penile underdevelopment. The his-tory obtained through the anamnesis, associated with the absence of traumatic episodes in the region and other associated congenital alterations, leads to the understanding that it is a urethral fistula not associated with hypospadias and has a congenital origin. The failure of the first surgical intervention provides relevant data in search of the probable causes of fistula formation. The impossibility of urethral catheterization associated with ischuria consequent to the obliteration of the defect is indicative that the urethral path was blind-ended or with a significant reduction of the lumen, and the resulting increase in pressure can be considered a factor for the formation of the fistula.

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The study of spinal surgery in dogs has limitations for the standardization of the sample, due to the difficulty of obtaining animals of the same breed, sex, and age. Thus, the use of the rabbit as an animal model is suggested. Morphometric studies are important to assess the anatomical compatibility between the two species. Furthermore, the growing interest in the rabbit as a pet and the common occurrence of iatrogenic fractures in its caudal lumbar spine emphasize the need for these studies. Eight spinal segments (L1-S3) from adult dogs, between 3 and 5kg, and eight from New Zealand rabbits, between 3 and 5kg, adults, were submitted to cone beam computed tomographic examination. In the generated images, the length, height and width of the body and vertebral foramen were measured, in addition to the thickness of the cortical bone. The lumbar vertebrae of rabbits are longer than those of dogs, but they are smaller in width and height. The thickness of the cortical bone of the two species is similar. The morphometric differences found restrict the use of the rabbit as an animal model for the development of experimental surgeries in dogs.

Os estudos de cirurgias da coluna vertebral de cães apresentam limitações para a padronização da amostra, devido à dificuldade de se conseguir animais de mesma raça, sexo e idade. Dessa forma, sugere-se o uso do coelho como modelo animal. Estudos morfométricos são importantes para avaliar a compatibilidade anatômica entre as duas espécies. Além disso, o crescente interesse pelo coelho como animal de estimação e a ocorrência comum de fraturas iatrogênicas na coluna lombar caudal enfatizam a necessidade desses estudos. Oito segmentos de coluna vertebral (L1-S3) de cães adultos, entre 3 e 5kg, e oito de coelhos adultos, da raça Nova Zelândia, entre 3 e 5kg, foram submetidos a exame tomográfico computadorizado de feixe cônico. Nas imagens geradas, foram mensurados o comprimento, a altura e a largura do corpo e do forame vertebral, além da espessura do osso cortical. Pode-se observar que as vértebras lombares dos coelhos são mais compridas do que as dos cães, porém apresentam largura e altura menores. A espessura do osso cortical das duas espécies é semelhante. As diferenças morfométricas encontradas restringem o uso do coelho como modelo animal para o desenvolvimento de cirurgias experimentais de cães.

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Ischemic stroke is the second leading cause of death and the leading cause of disability in the world. This is because current interventions are effective only in a narrow window of time. To prolong the period in which the interventions are effective, several in vivo animal models have been developed, among which an ischemic stroke is induced by introduction of an intraluminal catheter through the internal carotid artery or by inoculation of a thrombus into the common carotid artery. However, these models are not easy to execute in regions where access to specialized surgical material is difficult. We propose a study in a cadaveric model with Wistar rats with the aim of producing a surgical approach, like that achieved by introducing an intraluminal catheter at the base of the middle cerebral artery, using resources that are easily accessible to any laboratory. 40 rat carcasses, watchmaker tweezers, 0.17 mm diameter nylon suture and silicone were used to produce catheters, office clips, disposable cauterizer, 0.6 mm diameter soft wire as vascular clamp and hypodermic needles G -22 and G-32. Two surgical techniques for intraluminal introduction and occlusion are described. It was possible to introduce the catheter to the middle cerebral artery between 33 and 45 minutes, with a value in Colombian pesos for the total supplies of 200,000 COP / 27 USD for reusable materials. Although the procedure was reproducible in all the animals used, it is necessary to run this model in-vivo to observe its reproducibility by testing different treatments.