We conclude that double-barrelled wet colostomy is an excellent choice for patients who require concurrent urinary and faecal diversion, one that does not present technical difficulties and does not require a prolonged operating time. It avoids the complications frequently present in standard wet colostomy and does not rule out making a continent urinary reservoir later, in patients that meet healing criteria.

BACKGROUND: Despite the rich vascular arcade of the stomach, gastric ischemia represents an important medical challenge and can be the consequence of obstructive or non-obstructive vascular processes of pathological or iatrogenic origin. AIM: To assess the effects of acute gastric ischaemia on the different regions of the stomach. METHOD: Fifteen New Zeland rabbits were divided into three groups: group 1, animals were observed during 3 h; group 2, during 6 h; group 3, during 12 h. Rabbit stomachs were subjected to devascularization of the greater and lesser curvatures. After predetermined time, the stomachs were removed for macro and microscopic studies. RESULTS: Haemorrhagic necrosis was more marked in the gastric fundus and body. In contrast, the antropylorus remained preserved in 80% of the animals. Necrosis of the gastric body and fundus mucosa were observed in all animals after 6 h and 12 h of ischaemia. CONCLUSION: Acute gastric ischaemia in rabbits produces haemorrhagic necrosis of the gastric fundus and body even in a short period of time. Beside this, the antropyloric region was significantly more resistant to ischaemia.

INTRODUÇÃO: A partir de 1991, a videolaparoscopia começou a ser considerada no tratamento de doenças colorretais. O aprimoramento da técnica cirúrgica associado aos benefícios encontrados em diversos estudos publicados levou a modificações nas perspectivas da videolaparoscopia. A partir da publicação do estudo COST as ressecções oncológicas laparoscópicas foram reconhecidas como alternativa viável, com resultados semelhantes à cirurgia convencional. PACIENTES E MÉTODOS: Realizou-se pesquisa através de formulário específico e consulta a prontuários dos principais serviços de coloproctologia de Belo Horizonte. Avaliando-se sexo, idade, indicação cirúrgica, procedimento realizado, técnica laparoscópica, complicações, conversão, estadiamento e recidiva (no caso de neoplasias). RESULTADOS: Foram levantados dados sobre 503 cirurgias colorretais laparoscópicas: 347 (68,9%) em mulheres e 156 (31,1%) homens. A técnica cirúrgica foi totalmente laparoscópica em 137 casos, vídeo-assistida 245 casos. O procedimento mais realizado foi a retossigmoidectomia (41,1%), seguido pela colectomia direita (12,5%), colectomia esquerda (6,9%). Doenças benignas foram responsáveis por 259 (51,5%) casos, destes as principais indicações cirúrgicas foram endometriose 126 (48,6%), pólipos 40 (15,4%), doença diverticular 30 (11,6%). Das 240 cirurgias realizadas por doenças malignas as mais frequentes foram retossigmoidectomia 102 (42,5%), colectomia direita 46 (19,1%), colectomia esquerda 18 (7,5%), amputação abdominoperineal 18 (7,5%). Houve 54 conversões (10.7%) dos casos, 12,9% (31/240) nos casos de neoplasias, 8,5% (22/259) nos de doenças benignas. Complicações sistêmicas ou cirúrgicas ocorreram em 31 (6,1%) e 56 (11,1%) casos, respectivamente. Foram registrados onze (2,18%) óbitos nos primeiros 30 dias após a cirurgia. CONCLUSÃO: O estudo atual foi o primeiro levantamento da implantação de cirurgias colorretais laparoscópicas realizado de forma multicêntrica em Minas Gerais. Os dados levantados são consistentes com registros nacionais de videocirurgia colorretal, mostrando a eficiência do método de aprendizado com realização de cirurgias com tutor. Além disso, que pequena parte das cirurgias colorretais são realizadas por via laparoscópica no estado, restritos apenas a centros especializados, sobrecarregando esses serviços e limitando o acesso para a população.

Introduction: Gastric ischemia represents an important medical challenge in pathology and surgical practice. Objective: The purpose of this study was to assess the effects of acute gastric ischemia on different regions of the stomach. Method: Rabbit stomachs were subjected to devascularization of the greater and lesser curvatures for 3, 6 and 12 hours. After these periods, the stomachs were removed for macro and microscopic analysis. Results: Hemorrhagic necrosis was more marked in the gastric fundus and body. In contrast, the antropylorus remained preserved in 100% of the rabbits after 3 hours of ischemia (group I), and in 80% of the rabbits after 6 and 12 hours of ischemia (groups II and III). Necrosis of the gastric body and fundus mucosa were observed in all animals after 6 and 12 hours of ischemia. Conclusion: We concluded that this experimental model of acute gastric ischemia was effective in producing hemorrhagic necrosis of the gastric fundus and body in rabbits even within a short period of time. Furthermore, the antropyloric region was preserved in most animals.

The purpose of this study was to verify the effect of testosterone depletion on healing of surgical skin wounds at different ages and post-operative periods. Forty-four Wistar male rats were divided into four groups: Group 1Y (n = 11) - young control, sham-operated rats (30-day old); Group 1A (n = 10) - adult control, sham-operated rats (3 to 4-month old); Group 2Y (n = 10) - young rats after bilateral orchiectomy; and Group 2A (n = 11) - adult rats after bilateral orchiectomy. After 6 months, a linear incision was performed on the dorsal region of the animals. The resistance of the wound healing was measured in a skin fragment using a tensiometer, on the 7th and 21st post-operative days. The wound healing resistance was higher in Group 1Y than in Group 2Y after 7 days (P < 0.05). Wound healing resistance at 21 days was higher than at 7 days in all groups (P < 0.05). Late wound healing resistance was not different between young and adult rats. It is concluded that bilateral orchiectomy diminished the wound healing resistance only in young animals at the 7th post-operative day.