Colocistoplastia seromuscular recubierta de urotelio. Un estudio experimental en ratas / Seromuscular colocystoplasty lined by urothelium. Experimental study in rats

Objetivo. Determinar qué técnica de ampliación vesical en ratas puede ofrecer los mejores resultados funcionales e histológicos. Diseño. Estudio experimental comparativo entre parámetros pre y postoperatorios de 60 ratas Wistar hembra divididas en cinco grupos según la técnica de ampliación vesical utilizada: sham, colocistoplastia (CC), colocistoplastia desmucosada (DCC), colocistoplastia seremuscular cubierta de urotelio (AADCC) y autoaumento vesical (AA). Instrumentalización. Cistometría preoperatoria.Ampliación vesical usando diversas técnicas. Cistomanometría al mes postoperatorio, previa al sacrificio del animal y extracción de la vejiga para su estudio histológico. Medición del volumen y presión de ruptura. Resultados. La técnica de enterocistoplastia seromuscular presenta una alta mortalidad en la rata (63,6 por ciento). El aumento del volumen vesical producido en los dos grupos que portaban injerto seromuscular fue escaso (0,22 +/- 0,5 y 0,47 +/- 0,3 ml) frente al grupo de control (0,11 +/- 0,4ml). Sólo la colocistoplastia estándar y el autoaumento vesical produjeron aumentos significativos tanto del volumen vesica (0,78+/-0,5 y 0,69+/-0,6 ml, respectivamente) como del volumen de ruptura. No se observaron diferencias significativas en cuanto a la presión de ruptura vesical (AU)

[Seromuscular colocystoplasty lined by urothelium. Experimental study in rats]. / Colocistoplastia seromuscular recubierta de urotelio. Un estudio experimental en ratas.

OBJECTIVE: To determine what technical of vesical extension in rat can offer the best functional and histological results. DESIGN: Comparative experimental study between pre and postoperative parameters of 60 female Wistar rats. The animals were divided in 5 groups using different techniques of vesical augmentation. Sham, colocystoplasty (CC), demucosalised colocystoplasty (DCC), demucosalised colocystoplasty lined by urothelium (AADCC), autoaugmentation (AA). INTERVENTIONS: Preoperative cystometrical study. Microsurgery for vesical augmentation. New cystometric study at the month, previous to the sacrifice of the animal and extraction of bladder for its histological study. Measurement of the volume and pressure of rupture. RESULTS: The technique of seromuscular enterocistoplasty presents the high mortality in the rat (63.6%). The increase of the vesical volume in both groups that carried seromuscular grafts was little (0.22 +/- 0.5 and 0.47 +/- 0.3 ml) in front of the control group (0.11 +/- 0.4 ml). Only standard colocystoplasty and bladder autoaugmentation produced significant increases on vesical volume (0.78 +/- 0.5 and 0.69 +/- 0.6 ml, respectively) and rupture volume. There were not observed significant differences on vesical rupture pressure.

[Section of the sublingual frenulum. Are the indications correct?]. / Sección del frenillo sublingual. Son las indicaciones correctas?

OBJECTIVE: To see the relationship of the lingual frenum with speech and other oral functions, evaluating the surgical indications and the results of frenectomy. MATERIAL AND METHODS: In 1997 we operated 72 children with sublingual frenulum, a telephone questionnaire to the mothers of these patients was done, obtaining data about: age at surgery, professional reasons for referral, preoperative findings, pre-post operative speech therapy, place of surgery and type of anesthesia and mother's impression about the final result. RESULTS: Fifty valid questionnaires were obtained, the mean age at frenectomy was 3.03 years, 38% of children were sent due to speech problems, 60% due to some degree of tongue-tie and 2% due to dentofacial developmental anomalies. In 70% the patients were sent by a pediatrician and in 14% by a speech therapist. In 20% preoperative speech therapy was done and postoperatively in 30%. In 48% of cases, aged less than 2 years, speech was not possible to be evaluated. In the 11 cases with questionable results, a multidisciplinary reevaluation showed 7 cases with lingual dysfunction and poor tongue control, 4 cases with deglutitory anomalies and 3 cases with orofacial occlusal problems secondary to lingual dysfunction or altered oral habits. CONCLUSIONS: The presence of a nondisturbing lingual frenulum does not justify its surgical section, the frenectomy is indicated only in presence of altered oro-lingual functions caused by the tongue-tie such as: speech problems, errors of bite and deglutition, lingual dysfunction and anomalous oral habits.