[Intestinal lengthening techniques: an experimental model in dogs]. / Técnicas de alargamiento intestinal: un modelo experimental en perros.

OBJECTIVE: To compare two intestinal lengthening procedures in an experimental dog model. BACKGROUND: Intestinal lengthening is one of the methods for gastrointestinal reconstruction used for treatment of short bowel syndrome. The modification to the Bianchi's technique is an alternative. The modified technique decreases the number of anastomoses to a single one, thus reducing the risk of leaks and strictures. To our knowledge there is not any clinical or experimental report that studied both techniques, so we realized the present report. METHODS: Twelve creole dogs were operated with the Bianchi technique for intestinal lengthening (group A) and other 12 creole dogs from the same race and weight were operated by the modified technique (Group B). Both groups were compared in relation to operating time, difficulties in technique, cost, intestinal lengthening and anastomoses diameter. RESULTS: There were no statistical difference in the anastomoses diameter (A = 9.0 mm vs. B = 8.5 mm, p = 0.3846). Operating time (142 min vs. 63 min) cost and technique difficulties were lower in group B (p < 0.0001). Intestinal lengthening was greater in group B (p = 0.0006). At the end of surgery as well as four hours later, all except one of the anastomoses (of Group B) and intestinal segments had good blood supply and were patent along their full length. CONCLUSION: Bianchi technique and the modified technique offer two good reliable alternatives for the treatment of short bowel syndrome. The modified technique improved operating time, cost and technical issues.

Irrigación local de ketorolaco para el control del dolor de las heridas quirúrgicas / Transoperative instilation of ketarolac in surgical wounds for control of postoperative pain

Se estudiaron 30 pacientes portadores de hernia inguinal no complicada, los cuales fueron intervenidos de hernioplastía inguinal. Todos los pacientes recibieron la misma técnica anestésica con bloqueo peridural con 15 ml de lidocaína al 2 por ciento más 5 ml de solución inyectable y la misma técnica de reparación quirúrgica (Mc Vay-Bassini). Antes del cierre de la incisión, el cirujano irrigó las incisiones en la modalidad de doble ciego con una de dos soluciones en estudio: 30 mg de ketorolaco más 5 ml de solución salina y solución placebo (5 ml de solución salina). Posteriormente los pacientes se dividieron en dos grupos de 15 pacientes cada uno: grupo 1, los pacientes irrigados con ketorolaco y el grupo 2 irrigado con placebo. El análisis estadístico se efectuó por medio del método de cohortes comparativas.La intensidad del dolor fue evaluada por medio de la Escala Análoga Verbal del Dolor a las 2, 4, 8, 12 y 24 horas del postoperatorio, encontrándose que la intensidad del dolor fue menor en el grupo irrigado con ketorolaco, con efecto máximo a las 8 horas y con notable disminución del empleo de analgésicos de rescate.