Acta cirurgica brasileira最新文献

Purpose: To compare early- and medium-term postoperative outcomes of unilateral inguinal hernia repair performed using the Lichtenstein and Prolene hernia system (PHS) techniques in a public teaching hospital.

Methods: A retrospective analysis of 897 patients undergoing primary unilateral inguinal hernioplasty (406 with Lichtenstein and 491 with PHS) from January 2011 to March 2025 was conducted. Clinical, intraoperative, and postoperative data were collected and compared. Statistical analysis included t-tests, Mann-Whitney, Fisher's exact, and χ2 tests.

Results: Groups were not entirely homogeneous in preoperative profiles. The mean age was similar (p = 0.85), with predominance of males (94.87%). The operative time was significantly shorter for the PHS group (68.83 ± 24.84 versus 76.23 ± 26.90 min; p < 0.01). No significant differences were observed in postoperative complications, chronic pain, sensory dysfunction, or recurrence. Hospitalization was less frequent with the PHS technique (4.27 versus 12.8%; p < 0.01). Greater preference for local anesthesia was observed in the PHS group (20.77 versus 4.68%; p < 0.01).

Conclusion: Both techniques proved effective and safe, but the PHS technique showed advantages regarding operative time and hospitalization rate. However, limited sample size and absence of cost and return-to-activity data restrict broader generalizations. Further prospective randomized studies are needed.

Purpose: To verify the differences in the reversibility of renal function and damage in rats of different ages with unilateral ureteral obstruction (UUO).

Methods: Sixty rats were divided into three different groups, newborns, young, and adults. Twenty-one were sham operated. After UUO, the animals were subdivided into four groups: obstruction (two weeks and sacrifice O2); UUO two weeks, obstruction release for two weeks and sacrifice (R2); UUO for four weeks and sacrifice (O4); and UUO for four weeks, obstruction release for two weeks and sacrifice (R4). Urine was collected for creatinine, urea, total protein, and albumin dosages, and kidneys for morphological studies.

Results: Younger rats presented more extensive destruction of renal parenchyma, with some remaining normal tissue healthier in comparison to older rats. The protein excretion by older rats was not different between the groups obstructed for different periods, albuminuria was progressively higher in rats obstructed for longer periods, and after relief of obstruction, there was no difference between newborn rats obstructed for different periods. The younger pyelostomized rats presented higher albumin excretion. Creatinine excretion was worsened in rats after obstruction.

Conclusion: Shorter obstruction periods lead to better prognosis, and younger rats showed better recovery after relief of obstruction than older ones.

Purpose: To investigate the potential protective effects of ononin on cecal ligation puncture (CLP) induced sepsis rat model.

Methods: CLP was used to induce sepsis in rats and then treated with ononin at doses of 25 and 50 mg/kg intraperitoneally for seven days. The daily assessment included measurements of food and water intake, as well as body weight in the different rat groups. The study also examined the effects of ononin on survival rates, level of tumor necrosis factor (TNF)-α, interleukin (IL)-16, IL-6, C-reactive protein in the serum, and markers of oxidative stress in tissue homogenates of rats. The weight of spleen and lung tissue were also estimated in ononin-treated sepsis group. Additionally, histopathological examinations of lung and liver tissues were conducted in sepsis rats using hematoxylin and eosin staining.

Results: The ononin-treated group showed significant improvements in food and water intake, as well as body weight, compared to the sepsis group of rats. Survival rate was also improved in the ononin-treated group. Ononin ameliorates oxidative stress and inflammatory mediators in sepsis rats. Histopathological changes (liver and lung tissue) were observed to be ameliorated in the group of rats treated with ononin versus the sepsis group.

Conclusion: Ononin enhances survival rate in sepsis in rats by reducing inflammation and oxidative stress.

Purpose: To investigate the protective effect of trans-anethole in experimental traumatic brain injury (TBI) in mice.

Methods: Thirty-five adult mice were divided into five groups (control, TBI, TBI+A40, TBI+A80, and TBI+A160). No treatment was performed in the control group. The treated groups (TBI+A40, TBI+A80, and TBI+A160) received 40, 80 or 160 mg/kg trans-anethole treatment, respectively. At the end of the experiment, the brains of the sacrificed animals were removed, and laboratory analyses were performed.

Results: Malondialdehyde (MDA) levels in brain tissue of TBI and TBI+A40 were significantly increased, while MDA levels of TBI+A80 and TBI were similar. TBI+A160 and control tissue MDA levels were similar (p > 0.05), significantly different from TBI (p < 0.01). Immunodensity analyses showed that there was a significant difference between the control and TBI in terms of Bax, caspase 3, tumor necrosis factor-α (TNF-α) and interleukin- (IL)-1β immunoexpression. TBI+A40 immunoexpression was similar to TBI (p > 0.05), significantly different from the control groups (p < 0.05). In TBI+A80 and TBI+A160, pro-apoptotic Bax and caspase 3, pro-inflammatory TNF-α and IL-1β levels were also significantly improved. Immunoexpression levels of TBI+A160 and control were similar (p > 0.05).

Conclusion: in our study, trans-anethole treatment had a dose-dependent neuroprotective potential against trauma-induced neurodegeneration.

Purpose: Adequate microcirculation is essential for regeneration and survival of flaps. The perfusion pattern can be influenced by the vascular pedicle's properties in various flap types. We aimed to describe a refined musculocutaneous flap model with viability measurements, studying local, interpolated and transferred (free) flap types in rats.

Methods: Wistar rats were subjected to three experimental groups (n = 8/each). Beside controls, in two groups cutaneous maximus musculocutaneous flaps were prepared bilaterally. The right flaps were sutured back (local flap), the left one was transposed to the frontal chest wall (interpolated flap). In another group, left flap was transferred to the inguinal region performing microvascular anastomoses. Flaps' temperature, blood flow, and microcirculation were assessed before/after operation and on the 14th postoperative day.

Results: The flaps' temperature didn't worsen, but values moderately decreased in transferred flaps. The pedicle's blood flow didn't change significantly after preparation. The transferred flaps' values lowered by the 14th day. Microcirculatory parameters decreased postoperatively, significantly in interpolated and transferred flaps, and completely normalized by the 14th day.

Conclusion: Tissue perfusion and microcirculatory pattern were sufficient for flap survival and wound healing. The refined cutaneous maximus musculocutaneous flap model can be useful in studies comparing local, interpolated and transferred flaps.

Purpose: To evaluate correlations between anthropometric tools for visceral fat assessment, including waist circumference (WC) and sagittal abdominal diameter (SAD), by computed tomography (CT)-derived visceral fat volume in patients with rectal adenocarcinoma.

Methods: This comparative cross-sectional study included 138 participants: rectal adenocarcinoma patients (group 1, n = 69) and controls (group 2, n = 69). Assessed variables were weight, body mass index (BMI), bioelectrical impedance analysis (BIA), WC, SAD, and CT-derived visceral fat volume measured with Fat Tissue (Syngo.Via VB20, Siemens). CT analysis was restricted to group 1.

Results: Median ages in groups 1 and 2 were 60 and 53 years, respectively (p < 0.0008). CT revealed sex-based differences in visceral fat: 20.91 cm3 in females and 31.29 cm3 in males (p = 0.0043). WC and SAD demonstrated statistically significant correlations with CT-derived visceral fat in group 1 (p < 0.0001).

Conclusion: WC and SAD correlated with CT-derived visceral fat in rectal adenocarcinoma patients. These exploratory findings require validation by larger studies with multivariable analyses to establish predictive value and clinical applicability.

Purpose: To evaluate the regenerative efficacy of an experimental biodegradable nerve conduit composed of polycaprolactone and açaí-derived polyurethane, used for peripheral nerve repair, in comparison with different reconstructive techniques.

Methods: Wistar rats (n = 48) were allocated into six groups (n = 8): normality (NG), denervated (DG), burial (BG), nerve autograft (NAG), açaí-based neurotube (ANG), and vein autograft (VAG). Sciatic functional index, electrophysiological parameters, and histomorphometry were assessed after 12 weeks.

Results: NAG and ANG showed significant functional recovery, with ANG being the only group to demonstrate progressive improvement (p = 0.009). Electrophysiological analysis revealed higher amplitude and lower latency in NAG, followed by ANG and VAG. Histomorphometric analysis showed increased axonal density in ANG and NAG compared to non-reconstructed groups (p = 0.004 and p = 0.007, respectively).

Conclusion: The polycaprolactone/açaí-based conduit demonstrated regenerative performance comparable to autologous nerve grafts.

Purpose: Body weight, blood glucose, and hypothalamic ghrelin receptors were monitored in an animal model of obesity after being treated with sleeve gastrectomy.

Methods: Forty-two adult male Wistar rats were randomized into two groups: a non-obese group (standard chow); and an obese group, in which obesity was induced by feeding liquid enteral formula Ensure Plus. Each group was divided according to the surgery performed (sham operation or sleeve gastrectomy) and the time of sacrifice after surgery (14 or 28 days). Body weight and capillary blood glucose were monitored throughout the pre- and postoperative periods. Microscopic sections of the parietal cortex, thalamus, hypothalamus, and hippocampus were treated by immunohistochemical reaction with polyclonal anti-ghrelin receptor antibody. Positivity was determined by identifying labeled nuclei and cytoplasm in the brain cells.

Results: Sleeve gastrectomy induced effective weight loss (p < 0.001) and reduction in the hypothalamic ghrelin receptor expression (p = 0.04). Weight loss was not directly influenced by the receptor expression. There was no significant impact on capillary glycemia.

Conclusion: Sleeve gastrectomy alters GHSR1a receptors, decreasing their expression and body weight. However, weight loss is not directly related to the GHSR1a expression status.

Purpose: To scrutinize the protective effect of alpinumisoflavone against the acute reflux esophagitis (RE) in the rats and to explore the underlying mechanism.

Methods: RAW 264.7 cells were used for in-vitro study, and MTT assay was used to access the cell viability. The cells were treated with lipopolysaccharide (LPS) and estimation the inflammatory cytokines and parameters. A surgical procedure was performed for the induction of RE followed by the oral administration of alpinumisoflavone (5, 10 and 15 mg/kg). The esophagitis lesion score, gross esophageal score, damage ratio, pH and gastric volume, NO level, alcian blue, H2O2, free iron, calcium, antioxidant, inflammatory cytokines and inflammatory parameters were estimated.

Results: Alpinumisoflavone treatment significantly (p < 0.001) suppressed cell viability and NO levels, along with a reduction in inflammatory cytokines like tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 and inflammatory parameters such as cyclooxygenase-2 (COX-2), prostaglandin E22 (PGE2), and inducible nitric oxide synthase (iNOS) against the LPS treatment. Alpinumisoflavone treated group rats suppressed the esophagitis lesion score, gross esophageal score damage ratio, and gastric volume and improved the pH level. Alpinumisoflavone treatment significantly (p < 0.001) suppressed the level of NO level, alcian blue, H2O2, free iron and calcium. Alpinumisoflavone significantly (p < 0.001) altered the level of antioxidant parameters such as malondialdehyde, superoxide dismutase, glutathione, glutathione peroxidase, catalase; inflammatory cytokines viz., TNF-α, IL-6, IL-1β, IL-10, IL-18; and inflammatory parameters including COX-2, NF-κB, and PGE2.

Conclusion: Alpinumisoflavone ameliorates the acute reflux esophagitis via suppression of inflammatory parameters.

[This corrects the article doi: 10.1590/acb404925].