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OBJETIVO: Este estudo analisou anastomoses intestinais por sutura manual e por compressão com anel biofragmentável, sob retardo cicatricial pela administração parenteral de corticosteróides. MATERIAL E MÉTODOS: Vinte cães, entre 15 e 20 kg, foram divididos em grupos controle e teste, este submetido à administração intramuscular de hemissuccinato de hidrocortisona, de 25 a 33 mg/kg/dia, do 30º dia pré-operatório ao 7º dia pós-operatório. Em ato cirúrgico, cada animal foi submetido a duas secções cólicas, com anastomoses por sutura manual em plano único extramucoso e por compressão com anel biofragmentável. Os espécimes foram sacrificados sete dias após o procedimento para avaliação das anastomoses. RESULTADOS: No pós-operatório ocorreram um óbito no grupo teste e dois óbitos no grupo controle por fístula não bloqueada nas anastomoses por compressão com anel. Houve, estatisticamente, incidência semelhante de aderências, fístulas, dilatação aferente e obstrução, nos métodos em comparação. À microscopia, houve deficiência de regeneração mucosa nas anastomoses por compressão. Análise histológica por computador evidenciou nas anastomoses por compressão, maior reação inflamatória, maior edema de submucosa e formação de cicatrizes alargadas. CONCLUSÕES: Com o anel biofragmentável, em anastomoses colocólicas sob retardo de cicatrização induzido por corticosteróides, foram obtidos resultados semelhantes aos da sutura manual quanto à incidência de complicações pós-operatórias; o anel, entretanto, determinou pior regeneração mucosa e maior reação inflamatória cicatricial.BACKGROUND: This study analyzed intestinal anastomoses by manual suture and by compression with biofragmentable ring under delay of cicatrization administering parenteral corticoids. MATERIAL AND METHODS: Twenty dogs were divided into two groups: control and test, the latter submitted to intramuscular administration of hydrocortisone hemisuccinate, 25 to 33 mg/kg/day, on the 30th preoperative and 7th postoperative days. During surgery, each animal underwent two colon sections with anastomosis by manual suture in a single extramucous plane and compression with biofragmentable ring. The animals were sacrificed 7 days after the procedure to evaluate the anastomoses. RESULTS: In the postoperative period, one death occurred in the test group and two in the control group, caused by nonblocked fistula in the anastomoses by ring compression. Statistically, there was a similar incidence of adherences, fistulas, afferent dilatation and obstruction using comparison methods. On microscopy, deficiency in mucous regeneration of the anastomoses by compression was observed. Computerized histological analysis evidenced in the anastomoses by compression, a greater inflammatory reaction, greater edema of the submucous membrane and enlarged scars. CONCLUSIONS: It was concluded that, with the biofragmentable ring, in colonic anastomosis under delay of cicatrization induced by corticoids, similar results to manual suture regarding to postoperative complications incidence were obtained; ring, however, determined worse mucous regeneration and greater cicatricial inflammatory reaction.

The present report documents the successful outcome in three patients with a unilateral recurrent laryngeal nerve paralysis managed with an intracordal injection of autologous fat who ultimately experienced a complete recovery of function. Such data demonstrates the safety of intracordal autologous fat injection in patients who ultimately recover function.

Images Figs. 6-8 Figs. 1-5

In previous studies we compared the relative value of alternative methods for disinfecting the hands of nurses and surgeons and the skin of operation sites, but a number of relevant questions were not considered. For disinfection of the operation site alcoholic solutions of chlorhexidine (0.5%) and iodine (1%) were found to be equally effective and superior to a number of other agents (Lowbury, Lilly, and Bull, 1960), but we did not include laurolinium acetate, which was later reported by Verd?n (1961) to be more effective than nine other antiseptic prepara tions, including 1 % iodine in alcohol ; nor did we examine the removal of spore-bearing organisms. In studies on the disinfection of hands we confirmed the cumulative effect of

THE PERSISTENCE of a part of the vitello-intestinal duct as a solitary diverticulum of the ileum was was described by Ruysch in 1701, but is eponymously linked with the name of Johann Frederick Meckel, who in 1812 first described it accurately. Many complications of surgical importance due to the presence of a Meckel's diverticulum have been described and commented on; one which has received comparatively little attention, perhaps owing to its rarity, is that of perforation by a foreign body. The purpose of this report is to record a further case of this occurrence, and to present a bibliography of the other 49 cases which can be found in the world literature.

Nine cases of malignant lymphoma of the thyroid are described; the clinical features and histological patterns are recorded and the latter related to results of serological tests for thyroid antibodies. The value of such tests in clinical assessment is discussed. The distribution of metastases and their predilection for the gastrointestinal tract is noted.

A series of 53 cases of chronic pancreatic disease is described and attention drawn to the frequency with which symptoms are persistent rather than intermittent. A plea is made for the use of the term `progressive9 rather than `relapsing9 in describing many of these cases. Alcohol was an unimportant factor in the aetiology. The possibility of achieving an accurate and early diagnosis using the serum secretin/pancreozymin test is emphasized. The frequent relief of symptoms and the prevention of progress of the disease by surgery, especially sphincterotomy, is recorded.