Morbidity and mortality associated with loop ileostomy closure procedures in a reference service in coloproctology in Recife, Pernambuco / Morbimortalidade associada aos procedimentos de fechamento de ileostomia em alça em um serviço de referência em coloproctologia em Recife, Pernambuco (PE)

Objective: To evaluate the morbidity and mortality related to the surgical procedure of loop ileostomy closure, in a reference service in coloproctology, as well as possible variables that may be related to a higher frequency of complications. Methods: A retrospective study evaluated 66 procedures of loop ileostomy closure, performed between December 2005 and December 2017, at the coloproctology service of Barão de Lucena Hospital, in Recife, Brazil. Results: There were complications in 20 (30.3%) patients, 11 of whom were classified as grade I (Clavien-Dindo), and 9 of whom were classified as grade II to V. In 7.6% of the cases, one or more surgical reassessments were required. Mortality was 1.5%. There was no statistical relevance in the correlation of the studied variables with the occurrence of complications. Conclusion: Loop ileostomy closure presents an important morbidity, reaching more than 30%, although mortality is low. The analyzed variables did not show significant statistics for a higher occurrence of complications. (AU)

Objetivo: Avaliar a morbimortalidade relacionada ao procedimento cirúrgico de fechamento ileostomia em alça, em um serviço de referência em coloproctologia, bem como possíveis variáveis que possam se relacionar com uma maior frequência de complicações. Métodos: Estudo retrospectivo, com análise de prontuários de 66 procedimentos de fechamento de ileostomia em alça, realizados entre dezembro de 2005 e dezembro de 2017, no serviço de coloproctologia do Hospital Barão de Lucena, em Recife, PE. Resultados: Houve complicações em 20 (30,3%) pacientes, sendo 11 delas classificadas como grau I (Clavien-Dindo) e 9 classificadas de grau II a V. Em 7,6% dos casos, houve necessidade de uma oumais reabordagens cirúrgicas. Amortalidade foi de 1,5%. Não houve relevância estatística na correlação das variáveis estudadas com a ocorrência de complicações. Conclusão: O procedimento cirúrgico de fechamento de ileostomia apresenta morbidade importante, podendo chegar a mais de 30%, embora a mortalidade seja baixa. As variáveis analisadas não demonstraram significância estatística para maior ocorrência de complicações. (AU)

Effects of bacterial cellulose gel on the anorectal resting pressures in rats submitted to anal sphincter injury.

The aim of this study is to evaluate if a gel of bacterial cellulose gel can revert the loss of anal resting pressure after anorectum sphincter injury in rat model, elected as a model to simulate fecal incontinence. Thirty-nine animals were equally divided into three groups: Control (CG), Sphincter injury plus Saline injection (SG) and Sphincter injury plus Bacterial Cellulose Gel injection (BCG). Anal pressure at rest was assessed for all animal in the three groups using anorectum manometry. Saline and Gel groups were subject to anorectum sphincter injury to reduce the anal pressure at rest. Fifteen days later Saline or Gel was injected into the anorectum, according to their groups. Sixty days later first manometry, the anorectum of all animals were removed and processed histologically. The CG group showed maintenance of their mean anorectal resting pressure levels; SG presented a fall in their mean anorectal resting pressure. The BCG presented a significant elevation of the mean anorectal resting pressure levels, surpassing the pressure of CG. The gel of bacterial cellulose remained at the injection site and was neovascularized, colonized by fibroblasts and dense conjunctive tissue. Those data suggest that BC can be used as a future filling agent treatment for fecal incontinence in clinical trial protocols.