RESUMO
INTRODUCTION: Pancreatic malignant tumors are resectable at diagnosis in only 15% to 20% of cases and invasion of vascular structures is commonly present. Therefore, extended resections are needed for adequate local control and negative margins. However, morbidity and mortality associated with these enlarged resections are limiting factors. The aim of this study was to correlate demographic and technical aspects that influenced early and late outcomes. MATERIALS AND METHODS: Between October 2007 and May 2019, 523 pancreatic surgeries were performed, of which 72 required vascular resections. Clinical and histopathological data, surgical techniques, and perioperative parameters were analyzed in a prospectively collected database. RESULTS: Of the 72 cases of vascular resection, 31 were male and 41 females with a mean age of 60.9 years (34-81). The most commonly affected vascular structure was the portal vein (in 40.3%). Free margins were obtained in 77.8% of cases. Postoperative mortality rate at 60 days was 13.9%. American Society of Anesthesiologists (ASA) and age were the most important predictors of major complications. CONCLUSION: Extended resections with vascular involvement in pancreatic surgeries are feasible and safe; furthermore, patient selection plays are key. ASA and age were the most important factors in the decision-making process for extended resections.
Assuntos
Veias Mesentéricas/cirurgia , Invasividade Neoplásica , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Veia Porta/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Carcinoma Ductal Pancreático/mortalidade , Carcinoma Ductal Pancreático/patologia , Carcinoma Ductal Pancreático/cirurgia , Colangiocarcinoma/mortalidade , Colangiocarcinoma/patologia , Colangiocarcinoma/cirurgia , Estudos de Coortes , Feminino , Artéria Hepática/patologia , Artéria Hepática/cirurgia , Humanos , Masculino , Artérias Mesentéricas/patologia , Artérias Mesentéricas/cirurgia , Veias Mesentéricas/patologia , Pessoa de Meia-Idade , Pancreatectomia , Neoplasias Pancreáticas/mortalidade , Veia Porta/patologia , Complicações Pós-Operatórias/epidemiologia , Estudos RetrospectivosRESUMO
Caveolae are plasma membrane invaginations enriched with high cholesterol and sphingolipid content; they also contain caveolin proteins in their structure. Endothelial nitric oxide synthase (eNOS), an enzyme that synthesizes nitric oxide (NO) by converting L-arginine to L-citrulline, is highly concentrated in plasma membrane caveolae. Hypertension is associated with decreased NO production and impaired endothelium-dependent relaxation. Understanding the molecular mechanisms that follow hypertension is important. For this study, we hypothesized that spontaneously hypertensive rat (SHR) vessels should have a smaller number of caveolae, and that the caveolae structure should be disrupted in these vessels. This should impair the eNOS function and diminish NO bioavailability. Therefore, we aimed to investigate caveolae integrity and density in SHR aortas and mesenteric arteries and the role played by caveolae in endothelium-dependent relaxation. We have been able to show the presence of caveolae-like structures in SHR aortas and mesenteric arteries. Increased phenylephrine-induced contractile response after treatment with dextrin was related to lower NO release. In addition, impaired acetylcholine-induced endothelium-dependent relaxation could be related to decreased caveolae density in SHR vessels. The most important finding of this study was that cholesterol depletion with dextrin induced eNOS phosphorylation at Serine1177 (Ser1177) and boosted reactive oxygen species (ROS) production in normotensive rat and SHR vessels, which suggested eNOS uncoupling. Dextrin plus L-NAME or BH4 decreased ROS production in aorta and mesenteric arteries supernatant's of both SHR and normotensive groups. Human umbilical vein endothelial cells (HUVECs) treated with dextrin confirmed eNOS uncoupling, as verified by the reduced eNOS dimer/monomer ratio. BH4, L-arginine, or BH4 plus L-arginine inhibited eNOS monomerization. All these results showed that caveolae structure and integrity are essential for endothelium-dependent relaxation. Additionally, a smaller number of caveolae is associated with hypertension. Finally, caveolae disruption promotes eNOS uncoupling in normotensive and hypertensive rat vessels and in HUVECs.
Assuntos
Cavéolas/patologia , Endotélio Vascular/fisiopatologia , Hipertensão/fisiopatologia , Artérias Mesentéricas/patologia , Espécies Reativas de Oxigênio/metabolismo , Acetilcolina/farmacologia , Animais , Aorta/metabolismo , Aorta/patologia , Cavéolas/metabolismo , Cavéolas/ultraestrutura , Células Endoteliais da Veia Umbilical Humana , Humanos , Hipertensão/metabolismo , Masculino , Artérias Mesentéricas/efeitos dos fármacos , Artérias Mesentéricas/metabolismo , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Fenilefrina/farmacologia , Ratos Endogâmicos SHR , Ratos Wistar , Vasodilatação/efeitos dos fármacos , Vasodilatadores/farmacologiaRESUMO
Human abdominal angiostrongyliasis (HAA) is a parasitic disease caused by the accidental ingestion of the nematode Angiostrongylus costaricensis in its larval form. Human infection can lead to severe ischemic and inflammatory intestinal lesions, sometimes complicated by life-threatening ileal perforations. Only one case had been reported in Martinique, an Island in the French Antilles, in 1988. We retrospectively reviewed the medical charts of patients diagnosed with abdominal angiostrongyliasis at the University Hospital of Martinique between 2000 and 2017. The objectives of this study were to evaluate the incidence and perform a descriptive analysis of the clinical, biological, radiological, and histopathological features of HAA in Martinique. Two confirmed cases and two probable cases were identified in patients aged from 1 to 21 years during the 18-year period, with an estimated incidence of 0.2 cases per year (0.003 case/year/100.000 inhabitants (IC95% = 0.00-0.05)). All patients presented with abdominal pain associated with high blood eosinophilia (median: 7.24 G/L [min 4.25; max 52.28 G/L]). Two developed ileal perforation and were managed by surgery, with diagnostic confirmation based on histopathological findings on surgical specimens. The other two cases were probable, with serum specimens reactive to Angiostrongylus sp. antigen in the absence of surgery. All cases improved without sequelae. The description of this case series highlights the need to increase awareness of this life-threatening disease in the medical community and to facilitate access to specific diagnostic tools in Martinique. Environmental and epidemiological studies are needed to broaden our knowledge of the burden of this disease.
TITLE: Infections par Angiostrongylus costaricensis à la Martinique, Antilles, de 2000 à 2017. ABSTRACT: L'angiostrongylose abdominale humaine (AAH) est une maladie parasitaire causée par l'ingestion accidentelle du nématode Angiostrongylus costaricensis sous sa forme larvaire. L'infection humaine peut conduire à des lésions intestinales ischémiques et inflammatoires sévères, parfois compliquées par des perforations iléales menaçant le pronostic vital. Un seul cas avait été signalé en Martinique, une île des Antilles françaises, en 1988. Nous avons revu rétrospectivement les dossiers médicaux des patients ayant reçu un diagnostic d'angiostrongylose abdominale au CHU de la Martinique entre 2000 et 2017. Les objectifs de cette étude étaient d'évaluer l'incidence et effectuer une analyse descriptive des caractéristiques cliniques, biologiques, radiologiques et histopathologiques de l'AAH en Martinique. Deux cas confirmés et deux cas probables ont été identifiés chez des patients âgés de 1 à 21 ans au cours de la période de 18 ans, avec une incidence estimée à 0,2 cas par an (0,003 cas / an / 100 000 habitants (IC95% = 0,00 − 0,05)). Tous les patients présentaient une douleur abdominale associée à une éosinophilie sanguine élevée (médiane: 7,24 G/L [min 4,25; max 52,28 G / L]). Deux ont développé une perforation iléale et ont été traités par chirurgie, avec une confirmation diagnostique basée sur les résultats histopathologiques sur des échantillons chirurgicaux. Les deux autres cas étaient probables, avec des échantillons sériques réagissant aux antigènes d'Angiostrongylus sp. en l'absence de chirurgie. Tous les cas se sont améliorés sans séquelles. La description de cette série de cas souligne la nécessité de sensibiliser davantage la communauté médicale à cette maladie potentiellement mortelle et de faciliter l'accès à des outils diagnostiques spécifiques en Martinique. Des études environnementales et épidémiologiques sont nécessaires pour élargir nos connaissances sur cette parasitose.
Assuntos
Infecções por Strongylida/epidemiologia , Dor Abdominal/parasitologia , Adolescente , Angiostrongylus/imunologia , Animais , Anticorpos Anti-Helmínticos/sangue , Criança , Pré-Escolar , Colo/diagnóstico por imagem , Colo/parasitologia , Colo/patologia , Eosinofilia/parasitologia , Feminino , Humanos , Íleo/parasitologia , Íleo/patologia , Incidência , Lactente , Masculino , Martinica/epidemiologia , Artérias Mesentéricas/parasitologia , Artérias Mesentéricas/patologia , Radiologia , Chuva , Estudos Retrospectivos , Estações do Ano , Infecções por Strongylida/sangue , Infecções por Strongylida/diagnóstico por imagem , Infecções por Strongylida/patologia , Adulto JovemRESUMO
Resumen Introducción: La enfermedad multianeurismática es una entidad patológica poco conocida, la cual presenta diversas etiologías, por lo que su localización, morfología y formas de presentación varían de un caso a otro. Caso clínico: Mujer de 51 años dislipémica. Acude por epigastralgia. Se realiza TC abdominal con resultados de hematoma retroperitoneal y aneurisma en arteria pancreática duodenal. Se practica cirugía urgente para evacuación del hematoma sin encontrarse más hallazgos. Durante el ingreso presenta crisis hipertensivas y se realiza nuevo AngioTC donde se visualizan múltiples lesiones en distintas arterias viscerales con posibilidad diagnóstica de vasculitis. Se decide no intervención en el momento actual y estudio de filiación. Discusión: La enfermedad multianeurismática es una entidad poco común, cuya etiología se determina de acuerdo con su correlación clínica e histopatológica con diversas posibles causas; sin embargo, establecer un diagnóstico en donde el cuadro clínico coincida al 100%, es un desafío. Es muy frecuente la afectación de las arterias viscerales a diferencia de los aneurismas de origen ateroesclerótico. El tratamiento quirúrgico es seguro y deberá iniciarse en los segmentos que estén causando la sintomatología. El tratamiento endovascular es menos invasivo siendo la técnica de elección en pacientes con elevada comorbilidad y en los casos de cirugía complicada con rotura.
Introduction: Multiple artery aneurysms are a rare pathological condition which may be caused by different etiologies. Therefore, its location, morphology and clinical presentation may vary in a case to case basis. Case report: A 51-year-old woman, prior history of dyslipedemia presents with upper abdominal pain. Abdominal tomographic scans showed aneurysm of the pancreaticduodenal artery and retroperitoneal hematoma. Emergent surgical evacuation of the hematoma was performed, with no other findings. In the postoperative period, the patient suffers hypertensive crisis and a new tomographic scan is conducted observing multiple dilations in different visceral arteries. The patient is treated conservatively and is being studied for a possible vasculitis. Discussion: Multi-aneurysmatic artery disease is a very rare entity, its etiology is determined by clinical and histopathological correlation. Although establishing a diagnosis in which the clinical presentation completely corresponds, is a real challenge. Unlike degenerative aneurysms due to atherosclerosis, multi-aneurysmatic disease commonly involves visceral arteries. Open surgery is considered safe treatment option and should be established in the segments causing symptoms. Endovascular treatment is less invasive, being the technique of choice in patients with high comorbidity and in cases of complicated surgery with rupture.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Artéria Esplênica/diagnóstico por imagem , Artéria Hepática/diagnóstico por imagem , Aneurisma/diagnóstico por imagem , Artérias Mesentéricas/diagnóstico por imagem , Artéria Esplênica/patologia , Angiografia por Tomografia Computadorizada , Artéria Hepática/patologia , Artérias Mesentéricas/patologiaRESUMO
AIMS: This study examined whether chronic treatment with losartan, an angiotensin II type 1 receptor (AT1R) antagonist, might reverse COX-2-mediated vascular dysfunction in mesenteric resistance arteries (MRA) from offspring of hyperglycaemic rats. MATERIALS AND METHODS: Male 12-month-old offspring of hyperglycaemic (O-DR) and normoglycaemic (O-CR) rats were treated with losartan (15mg·kg·day-1) during 2months. Third order MRA of untreated and losartan-treated O-DR and O-CR were mounted in wire myograph for isometric tension measurements. COX-2 expression was analyzed by Western blot; TxA2, PGE2 and PGF2α release was measured using commercial kits. KEY FINDINGS: O-DR showed increased blood pressure, impaired acetylcholine-induced vasodilation and increased noradrenaline-induced vasoconstriction than O-CR. All these parameters were normalized by losartan in O-DR. Pre-incubation of MRA with indomethacin (COX-1/2 inhibitor), NS-398 (COX-2 inhibitor) or tempol (superoxide dismutase mimetic) increased relaxation to acetylcholine and reduced contraction to noradrenaline only in O-DR. COX-2 expression, TxA2, PGE2 and PGF2α release were increased in O-DR. In losartan-treated O-DR, NS-398, indomethacin or tempol failed to produce any effect on acetylcholine or noradrenaline responses. Losartan treatment reduced COX-2 expression, TxA2, PGE2 and PGF2α release in O-DR. SIGNIFICANCE: The present results reveal that chronic losartan administration in O-DR normalizes endothelial function in MRA by correcting the existing COX-2 overexpression and the imbalance between endothelium-derived relaxing and contracting factors. These findings not only support the beneficial effects of AT1 receptor antagonist in O-DR, but also suggest the implication of angiotensin II as a putative mediator of hyperglycemia-programmed vascular dysfunction in rats.
Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Ciclo-Oxigenase 2/metabolismo , Hiperglicemia/complicações , Losartan/farmacologia , Artérias Mesentéricas/efeitos dos fármacos , Angiotensina II/metabolismo , Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Animais , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/patologia , Feminino , Losartan/administração & dosagem , Masculino , Artérias Mesentéricas/patologia , Gravidez , Ratos , Ratos Wistar , Vasoconstrição/efeitos dos fármacos , Vasodilatação/efeitos dos fármacosRESUMO
Vascular alterations are expected to occur in obese individuals but the impact of obesity could be different depending on the artery type. We aimed to evaluate the obesity effects on the relaxing and contractile responses and inflammatory and smooth muscle (SM) phenotypic markers in two vascular beds. Obesity was induced in C57Bl/6 mice by 16-week high-fat diet and vascular reactivity, mRNA expression of inflammatory and SM phenotypic markers, and collagen deposition were evaluated in small mesenteric arteries (SMA) and thoracic aorta (TA). Endothelium-dependent relaxation in SMA and TA was not modified by obesity. In contrast, contraction induced by depolarization and contractile agonists was reduced in SMA, whereas only contraction induced by adrenergic agonist was reduced in TA of obese mice. Obesity increased the mRNA expression of pro- and anti-inflammatory cytokines in SMA and TA. The expression of genes necessary for maintaining contractile ability was increased by obesity, but the increase was more pronounced in TA. Collagen deposition was increased in SMA, but not in TA, of obese mice. Although the endothelial function was still preserved, the SM of the two artery types was impaired by obesity, but the impairment was higher in SMA, which could be associated with SM phenotypic changes.
Assuntos
Endotélio Vascular/metabolismo , Inflamação/genética , Músculo Liso/metabolismo , Obesidade/genética , Animais , Aorta Torácica/metabolismo , Aorta Torácica/patologia , Colágeno/metabolismo , Dieta Hiperlipídica , Modelos Animais de Doenças , Endotélio Vascular/patologia , Regulação da Expressão Gênica , Humanos , Inflamação/patologia , Artérias Mesentéricas/metabolismo , Artérias Mesentéricas/patologia , Camundongos , Músculo Liso/patologia , Obesidade/patologia , RNA Mensageiro/genéticaRESUMO
Matrix metalloproteinase (MMP)-2 participates in hypertension-induced maladaptive vascular remodelling by degrading extra- and intracellular proteins. The consequent extracellular matrix rearrangement and phenotype switch of vascular smooth muscle cells (VSMCs) lead to increased cellular migration and proliferation. As calponin-1 degradation by MMP-2 may lead to VSMC proliferation during hypertension, the hypothesis of this study is that increased MMP-2 activity contributes to early hypertension-induced maladaptive remodelling in conductance and resistance arteries via regulation of calponin-1. The main objective was to analyse whether MMP-2 exerts similar effects on the structure and function of the resistance and conductance arteries during early hypertension. Two-kidney, one-clip (2K-1C) hypertensive male rats and corresponding controls were treated with doxycycline (30 mg/kg/day) or water until reaching one week of hypertension. Systolic blood pressure was increased in 2K-1C rats, and doxycycline did not reduce it. Aortas and mesenteric arteries were analysed. MMP-2 activity and expression were increased in both arteries, and doxycycline reduced it. Significant hypertrophic remodelling and VSMC proliferation were observed in aortas but not in mesenteric arteries of 2K-1C rats. The contractility of mesenteric arteries to phenylephrine was increased in 2K-1C rats, and doxycycline prevented this alteration. The potency of phenylephrine to contract aortas of 2K-1C rats was increased, and doxycycline decreased it. Whereas calponin-1 expression was increased in 2K-1C mesenteric arteries, calponin-1 was reduced in aortas. Doxycycline treatment reverted changes in calponin-1 expression. MMP-2 contributes to hypertrophic remodelling in aortas by decreasing calponin-1 levels, which may result in VSMC proliferation. On the other hand, MMP-2-dependent increased calponin-1 in mesenteric arteries may contribute to vascular hypercontractility in 2K-1C rats. Divergent regulation of calponin-1 by MMP-2 may be an important mechanism that leads to maladaptive vascular effects in hypertension.
Assuntos
Aorta Torácica/enzimologia , Proteínas de Ligação ao Cálcio/metabolismo , Hipertensão Renovascular/enzimologia , Metaloproteinase 2 da Matriz/metabolismo , Artérias Mesentéricas/enzimologia , Proteínas dos Microfilamentos/metabolismo , Remodelação Vascular , Resistência Vascular , Vasoconstrição , Animais , Aorta Torácica/efeitos dos fármacos , Aorta Torácica/patologia , Aorta Torácica/fisiopatologia , Modelos Animais de Doenças , Feminino , Hipertensão Renovascular/patologia , Hipertensão Renovascular/fisiopatologia , Artérias Mesentéricas/efeitos dos fármacos , Artérias Mesentéricas/patologia , Artérias Mesentéricas/fisiopatologia , Músculo Liso Vascular/enzimologia , Músculo Liso Vascular/patologia , Músculo Liso Vascular/fisiopatologia , Miócitos de Músculo Liso/enzimologia , Miócitos de Músculo Liso/patologia , Ratos Wistar , Transdução de Sinais , Remodelação Vascular/efeitos dos fármacos , Resistência Vascular/efeitos dos fármacos , Vasoconstrição/efeitos dos fármacos , Vasoconstritores/farmacologia , Vasodilatadores/farmacologia , CalponinasRESUMO
PURPOSE: Vogt´s antioxidant solution (red blood cells, Ringer's solution, sodium bicarbonate, mannitol, allopurinol and 50% glucose) or its modification including hydroxyethyl starch (HES) were tested for the prevention of splanchnic artery occlusion shock. METHODS: Seventy rats were distributed in treatment (3), control (1), and sham (3) groups. Ischemia and reperfusion were induced by celiac, superior mesenteric and inferior mesenteric arteries occlusion for 40 min, followed by 60 min reperfusion or sham procedures. Controls received saline, both treatment and sham groups received the Vogt's solution, modified Vogt's solution (replacing Ringer's solution by HES), or HES. Mean arterial blood pressure (MABP), ileal malondialdehyde (MDA) and plasmatic MDA were determined, and a histologic grading system was used. RESULTS: At reperfusion, MABP dropped in all I/R groups. Only HES treatment was able to restore final MABP to the levels of sham groups. Plasmatic MDA did not show differences between groups. Ileum MDA was significantly higher in the control and treatment groups as compared to the sham group. Histology ranking was higher in the only in control group. CONCLUSIONS: Hydroxyethyl starch was able to prevent hemodynamic shock but not intestinal lesions. Both treatments with Vogt's solutions did not show any improvement.
Assuntos
Derivados de Hidroxietil Amido/farmacologia , Artérias Mesentéricas/efeitos dos fármacos , Oclusão Vascular Mesentérica/prevenção & controle , Substitutos do Plasma/farmacologia , Traumatismo por Reperfusão/prevenção & controle , Animais , Modelos Animais de Doenças , Hemodinâmica/efeitos dos fármacos , Derivados de Hidroxietil Amido/uso terapêutico , Íleo/irrigação sanguínea , Íleo/patologia , Isquemia/prevenção & controle , Soluções Isotônicas/farmacologia , Soluções Isotônicas/uso terapêutico , Masculino , Malondialdeído/análise , Artérias Mesentéricas/patologia , Oclusão Vascular Mesentérica/patologia , Substitutos do Plasma/uso terapêutico , Ratos Wistar , Reprodutibilidade dos Testes , Circulação Esplâncnica/efeitos dos fármacos , Fatores de Tempo , Resultado do TratamentoRESUMO
PURPOSE: Vogt´s antioxidant solution (red blood cells, Ringer's solution, sodium bicarbonate, mannitol, allopurinol and 50% glucose) or its modification including hydroxyethyl starch (HES) were tested for the prevention of splanchnic artery occlusion shock. METHODS: Seventy rats were distributed in treatment (3), control (1), and sham (3) groups. Ischemia and reperfusion were induced by celiac, superior mesenteric and inferior mesenteric arteries occlusion for 40 min, followed by 60 min reperfusion or sham procedures. Controls received saline, both treatment and sham groups received the Vogt's solution, modified Vogt's solution (replacing Ringer's solution by HES), or HES. Mean arterial blood pressure (MABP), ileal malondialdehyde (MDA) and plasmatic MDA were determined, and a histologic grading system was used. RESULTS: At reperfusion, MABP dropped in all I/R groups. Only HES treatment was able to restore final MABP to the levels of sham groups. Plasmatic MDA did not show differences between groups. Ileum MDA was significantly higher in the control and treatment groups as compared to the sham group. Histology ranking was higher in the only in control group. CONCLUSIONS: Hydroxyethyl starch was able to prevent hemodynamic shock but not intestinal lesions. Both treatments with Vogt's solutions did not show any improvement. .
Assuntos
Animais , Masculino , Derivados de Hidroxietil Amido/farmacologia , Artérias Mesentéricas/efeitos dos fármacos , Oclusão Vascular Mesentérica/prevenção & controle , Substitutos do Plasma/farmacologia , Traumatismo por Reperfusão/prevenção & controle , Modelos Animais de Doenças , Hemodinâmica/efeitos dos fármacos , Derivados de Hidroxietil Amido/uso terapêutico , Íleo/irrigação sanguínea , Íleo/patologia , Isquemia/prevenção & controle , Soluções Isotônicas/farmacologia , Soluções Isotônicas/uso terapêutico , Malondialdeído/análise , Artérias Mesentéricas/patologia , Oclusão Vascular Mesentérica/patologia , Substitutos do Plasma/uso terapêutico , Ratos Wistar , Reprodutibilidade dos Testes , Circulação Esplâncnica/efeitos dos fármacos , Fatores de Tempo , Resultado do TratamentoRESUMO
Introduction: Ischemic postconditioning has been recognized as effective in the prevention of reperfusion injury in situations of ischemia and reperfusion in various organs and tissues. However, it remains unclear what would be the best way to accomplish it, since studies show great variation in the method of their application. Objective: To assess the protective effect of ischemic postconditioning on ischemia and reperfusion in rats undergoing five alternating cycles of reperfusion and ischemia of 30 seconds each one. Methods: We studied 25 Wistar rats distributed in three groups: group A (10 rats), which underwent mesenteric ischemia (30 minutes) and reperfusion (60 minutes); Group B (10 rats), undergoing ischemia (30 minutes) and reperfusion (60 minutes), intercalated by postconditioning (5 alternating cycles of reperfusion and ischemia of 30 seconds each one); and group C - SHAM (5 rats), undergoing only laparotomy and manipulation of mesenteric artery. All animals underwent resection of an ileum segment for histological analysis. Results: The mean lesions degree according to Chiu et al. were: group A, 2.77, group B, 2.67 and group C, 0.12. There was no difference between groups A and B (P>0.05). Conclusion: Ischemic postconditioning was not able to minimize or prevent the intestinal tissue injury in rats undergoing ischemia and reperfusion process when used five cycles lasting 30 seconds each one. .
Introdução: O pós-condicionamento isquêmico tem sido reconhecido como eficaz na prevenção das lesões de reperfusão em situações de isquemia e reperfusão em vários órgãos e tecidos. Entretanto, não está ainda claro qual seria a melhor maneira de realizá-lo, já que as publicações mostram grande variação de método no seu emprego. Objetivo: Avaliar o efeito protetor do pós-condicionamento isquêmico na isquemia e reperfusão intestinal em ratos, através de cinco ciclos alternados de 30 segundos de isquemia e 30 segundos de reperfusão. Métodos: Foram estudados 25 ratos Wistar, distribuídos em três grupos: grupo A (10 ratos), em que se realizou isquemia (30 minutos) e reperfusão (60 minutos) mesentérica; grupo B (10 ratos), isquemia e reperfusão, seguidos de pós-condicionamento isquêmico com 5 ciclos alternados de reperfusão e reoclusão, de 30 segundos cada; e grupo C (5 ratos), controle (SHAM). Ao final, ressecou-se um segmento do intestino delgado para análise histológica. Avaliaram-se os resultados pela classificação de Chiu et al. e procedeu-se ao tratamento estatístico. Resultados: As médias dos graus de lesão tecidual segundo a classificação de Chiu et al. foram: no grupo A, 2,77; no grupo B, 2,67; e no grupo C, 0,12. A diferença entre o resultado do grupo A com o resultado do grupo B não teve significância estatística (P>0,05). Conclusão: O pós-condicionamento isquêmico não foi capaz de minimizar ou prevenir a lesão tecidual intestinal de ratos submetidos ao processo de isquemia e reperfusão mesentérica quando utilizados cinco ciclos com duração de 30 segundos cada. .