RESUMO
As cirurgias endoscópicas transluminais por orifícios naturais ou NOTES (Natural Orifice Transluminal Endoscopic Surgery), significam um novo conceito de cirurgia uma vez que são produzidas pela hibridização de endoscopia e laparoscopia, culminando em uma modalidade cirúrgica com ausência de incisões abdominais. Diversas vias de acesso para a NOTES já foram descritas na literatura dentre elas: a via transvaginal, a transgástrica, a transuretral, a transcolônica e a transretal, sendo os acessos transvaginal e trangástrico os mais estudados até o momento. Apesar da NOTES apresentar vantagens como menor dor abdominal, rápida recuperação pós-operatória, menor risco de aderências e herniações, ausência de cicatriz e menor reposta inflamatória sistêmica, a necessidade de um fechamento seguro da víscera de acesso à cavidade abdominal, bem como adequada cicatrização do órgão ainda são desafios desta nova abordagem cirúrgica. Desta maneira, o presente trabalho tem por objetivo trazer uma revisão bibliográfica da cirurgia por orifícios naturais, como também suas implicações clínicas decorrentes dos diferentes acessos à cavidade abdominal.
RESUMO
As cirurgias endoscópicas transluminais por orifícios naturais ou NOTES (Natural Orifice Transluminal Endoscopic Surgery), significam um novo conceito de cirurgia uma vez que são produzidas pela hibridização de endoscopia e laparoscopia, culminando em uma modalidade cirúrgica com ausência de incisões abdominais. Diversas vias de acesso para a NOTES já foram descritas na literatura dentre elas: a via transvaginal, a transgástrica, a transuretral, a transcolônica e a transretal, sendo os acessos transvaginal e trangástrico os mais estudados até o momento. Apesar da NOTES apresentar vantagens como menor dor abdominal, rápida recuperação pós-operatória, menor risco de aderências e herniações, ausência de cicatriz e menor reposta inflamatória sistêmica, a necessidade de um fechamento seguro da víscera de acesso à cavidade abdominal, bem como adequada cicatrização do órgão ainda são desafios desta nova abordagem cirúrgica. Desta maneira, o presente trabalho tem por objetivo trazer uma revisão bibliográfica da cirurgia por orifícios naturais, como também suas implicações clínicas decorrentes dos diferentes acessos à cavidade abdominal.
RESUMO
Background: Biological membranes demonstrate superiority over synthetic ones for its biocompatibility and strength in the reduction of abdominal hernias. Recents tissue engineering researches add mesenchymal stem cells to biological membranes with the purpose of obtaining additional cellular proliferation and consequent muscle regeneration, using biological membranes as cellular scaffolds. This article aimed to study the influence of mesenchymal stem cells in muscle regeneration in abdominal hernias, reduced with biological membranes. Materials, Methods & Results: Adult Wistar rats underwent abdominal hernia-inducing. They were divided into two groups as to the form of treatment for the reduction of hernia: stem cells associated with biological membranes or only biological membranes. After the treatment the macro and microscopic reviews were carried out in days seven, 14 and 60 postoperatively. Preparation of bovine pericardium with glycerin 98% presented efficiency in decellularization and conservation, maintaining its strength and avoiding bacterial growth. The mesenchymal stem cells obtained from bone marrow of adult Wistar rats, had capacity of proliferation. The majority of the cells was positive for the expression of surface antigens CD44, CD29 and CD99 and was negative for CD 34. In the differentiation trials, the same cells were able to differentiate into adipocytes
Vários tipos de implantes, naturais ou sintéticos, vêm sendo testados no reparo cirúrgico de hérnias. As membranas biológicas, ou arcabouços dérmicos descelularizados, apresentam reduzida formação de aderência entre o implante e as vísceras, diminuição da formação de fístulas, infecções e recorrências. Também apresentam resistência suficiente para suportar a pressão abdominal, evitando deiscências e eviscerações. [...]
RESUMO
Background: Platelet rich plasma (PRP) is a blood-derived source of growth factors and several cytokines, which are essential for tissue regeneration and important for wound healing due to their angiogenic, mitogenic, and chemotactic activities. To date no protocol has been established for PRP production. Standardization of this technique should consider fundamental factors such as experimental model used, blood collection method, anticoagulant choice, rotation and amount of centrifugations, elapsed time between sample activation and its clinical use in order to ensure quality and biological effects of the product. This study aimed to compare three protocols for PRP achievement in order to evaluate platelet enrichment ability and method reproducibility for further use in clinical investigations regarding PRP therapeutic properties. Materials, Methods & Results: New Zealand higid rabbits whole blood was collected in tubes containing sodium citrate. Samples were obtained through exsanguination, via abdominal aortic puncture, and separated in four aliquots designed for PRP processing and basal platelet count. The count was conducted at the time blood was collected and after every concentration protocol. Methods were tested in triplicates, and three different individuals repeated each technique for three times, reaching 27 repetitions. Selected methodologies consisted in two c
O plasma rico em plaquetas derivado de sangue autólogo é definido como um volume de plasma com uma concentração plaquetária acima dos níveis fisiológicos. É uma fonte autógena e de baixo custo de fatores de crescimento (FC). FC são moléculas bioativas fundamentais no reparo e regeneração de diversos tecidos, capazes de estimular a mitogênese, angiogênese, quimiotaxia, proliferação e diferenciação celular. Entre os fatores liberados pelas plaquetas destacam-se: Fator de Crescimento Derivado de Plaquetas (PDGF), Fator de Crescimento Transformador Beta (TGF- ), Fator de Crescimento Endotelial Vascular (VEGF) e Fator de Crescimento Epitelial (EGF). [...]
RESUMO
Background: Ureteral ectopia is a congenital abnormality of the terminal segment of one or both ureters, in which the ureteral orifi ce is located distal to the trigone of the bladder. Ureteral ectopia results from dysembryogenesis of the ureteral bud due to its abnormal positioning along the mesonephric duct. It is frequently associated with other congenital anomalies of the lower urinary tract as urethral sphincter dysfunction, hydroureter and hydronephrosis. Ectopic ureters are classifi ed into two categories: extramural and intramural. Extramural ectopic ureters completely bypass the urinary bladder without anatomic attachment, opening directly into the urethra, vagina or uterus. Continuous or intermittent urinary incontinence is the most frequently reported clinical symptom associated with ureteral ectopia, and it is far more frequent in young bitches than in male dogs. Repositioning the distal segment of the ureter and ureteral orifi ce directly into the bladder may restore urinary continence throughout neoureterocistostomy.Case: A 3-month-old female poodle weighting 4 kg was referred to the Teaching Veterinary Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS), State of Rio Grande do Sul, Brazil, due to urinary incontinence, dysuria and severe vulvar pyodermatitis since it was 9 weeks old. Normal posturing and voiding of urine did occur, although only sm
Background: Ureteral ectopia is a congenital abnormality of the terminal segment of one or both ureters, in which the ureteral orifi ce is located distal to the trigone of the bladder. Ureteral ectopia results from dysembryogenesis of the ureteral bud due to its abnormal positioning along the mesonephric duct. It is frequently associated with other congenital anomalies of the lower urinary tract as urethral sphincter dysfunction, hydroureter and hydronephrosis. Ectopic ureters are classifi ed into two categories: extramural and intramural. Extramural ectopic ureters completely bypass the urinary bladder without anatomic attachment, opening directly into the urethra, vagina or uterus. Continuous or intermittent urinary incontinence is the most frequently reported clinical symptom associated with ureteral ectopia, and it is far more frequent in young bitches than in male dogs. Repositioning the distal segment of the ureter and ureteral orifi ce directly into the bladder may restore urinary continence throughout neoureterocistostomy.Case: A 3-month-old female poodle weighting 4 kg was referred to the Teaching Veterinary Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS), State of Rio Grande do Sul, Brazil, due to urinary incontinence, dysuria and severe vulvar pyodermatitis since it was 9 weeks old. Normal posturing and voiding of urine did occur, although only sm