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PURPOSE:To evaluate the effects of pneumoperitoneum with carbon dioxide and helium on renal function and morphology in a rat model. METHODS:Twenty four rats were randomized into three groups (n=8): gasless insufflation ('open', Pressure=0 mmHg), carbon dioxide pneumoperitoneum at 12 mmHg, and helium pneumoperitoneum at 12 mmHg; all lasting 90 minutes.. A cystostomy was performed and the bladder was emptied. At the end of the experiment, the urine produced, a blood sample and the left kidney of each animal were collected. The following variables were obtained: serum sodium, potassium, urea and creatinine, urine volume and creatinine. The creatinine clearance was estimated for each animal. The kidneys were stained with hematoxylin and eosin (HE) and evaluated by a pathologist blinded to the groups. RESULTS:The CO 2 and Helium groups did not differ in the variables evaluated. Both developed oliguria (p<0.001 vs. gasless). The CO 2 group presented hyperkalemia compared to gasless (p=0.05), which did not attain significance in the helium group. Histopathological analysis revealed mild hydropic degeneration and congestion in the three groups, with no significant difference among them. CONCLUSIONS:The type of gas resulted in no difference in the variables of renal function and morphology assessed. The increase in serum potassium was only observed with CO 2 insufflation suggests a combined effect of elevated intra-abdominal pressure and metabolic effects of pneumoperitoneum.

Os antimoniais pentavalentes (Antimoniato de N-metilglumina -Glucantime®) são fármacos de primeira escolha no tratamento da leishmaniose tegumentar americana (LTA). Apresentam a cardiotoxicidade como importante efeito adverso e é evidenciada por alterações no eletrocardiograma de repouso (ECG). O alargamento do intervalo QT corrigido (QTc) é a principal e potencialmente mais grave delas. O presente estudo teve como objetivo avaliar as alterações no ECG e sua frequência nos pacientes com LTA tratados com Glucantime® no Serviço de Dermatologia de nossa instituição. Para isso, um cardiologista avaliou os ECGs de 15 pacientes entre 18 e 59 anos de idade diagnosticados com LTA. Os exames foram realizados imediatamente antes, no 7º, 14º e 21º dias do tratamento. Desses pacientes, cinco (33%) desenvolveram algum distúrbio no eletrocardiograma, cuja frequência foi diretamente proporcional ao tempo de uso do fármaco. Bradicardia sinusal nova foi o mais comum (5/15 pacientes), seguida por alargamento do intervalo QTc (2/15 pacientes, os quais também apresentaram bradicardia). Não houve registro de complicações graves e nenhum paciente desenvolveu sintomatologia cardiovascular. Em apenas um caso foi necessária a interrupção do tratamento. A frequência de alterações no ECG observada é compatível com a relatada por estudos anteriores sobre o tema. Concluímos que a cardiotoxicidade dos antimoniais pentavalentes se manifestou de forma insidiosa, cumulativa, em proporção compatível com os relatos da literatura e sem repercussões clínicas.

PURPOSE:To evaluate the feasibility and safety of a new technique for laparoscopic segmental colectomy and primary anastomosis in the left colon of rats. METHODS: Thirty rats were randomly assigned to three groups of ten animals each. All animals underwent segmental resection of the left colon and end-to-end anastomosis. In Group I, the animals underwent laparoscopic surgery with carbon dioxide pneumoperitoneum at a pressure of 5 mmHg. In Group II, the animals underwent pneumoperitoneum with carbon dioxide at a pressure of 12 mmHg. In Group III, the control group, the animals underwent open surgery. All animals were reopened on the 7th postoperative day and were evaluated for peritonitis, abscesses, anastomotic dehiscence and bowel obstruction, and the anastomosis bursting pressure was measured. RESULTS:No obstructions, peritonitis or abscesses were found in any of the animals. An animal in Group I exhibited a blocked anastomosis leakage. The average anastomosis bursting pressure in the 30 animals was 187.02 ± 68.35 mmHg. There was no significant difference in the anastomosis bursting pressure among the groups (p = 0.503) CONCLUSION:The laparoscopic experimental model was feasible and safe for segmental colectomy and anastomosis of the left colon in rats.