Search

OBJETIVO: Pesquisar a eficácia da Submucosa de lntestino Delgado (SID) porcina na correção de estenoses esofágicas cervicais em cães. MÉTODOS: Para produzir estenose, 12 animais foram submetidos a ressecções de porção elíptica de 3,5X2,0 cm, na parede anterior do esôfago cervical, suturado por pontos de fio de algodão. O processo evolui por 90 dias, atingindo a estenose desejada e comprovada por esofagograma. Na seqüência, a lesão cicatricial produzida foi ressecada e substituída por enxerto de SID. Transcorridos 2 meses os animais foram submetidos a novo esofagograma. Aferiu-se então a largura esofágica (nas porções proximal e média do esôfago cervical) após a realização da estenose e pós-correção. Os animais foram submetidos a eutanásia, ao 60º dia de pós-correção, e à necropsia os esôfagos foram retirados e enviados ao laboratório de Anatomia Patológica. RESULTADOS: Não houve fístula ou infecção. Ocorreram reepitelização completa da mucosa, discreta reação infamatória e neovascularização moderada. A luz esofágica foi ampliada em 70% dos animais (43% ± 13% em média) (p = 0,2135). A medida da porção proximal, passou de 0,76cm para 0,95cm em média (p=0,02). Não houve alteração significativa em relação a porção medial. CONCLUSÃO: A SID demonstrou ser, no cão, enxerto eficaz para correção de estenoses esofágicas, integrando-se nitidamente à sua parede e substituindo-a de forma adequada. PURPOSE: The objective of the present study is evaluating the efficiency of porcine Small Intestinal Submucosa (SIS) as graft in the managemant of stenotic cervical esophagus lesions in dogs. METHODS: Twelve dogs were submitted to resection of an eliptic (3,5X2,0 cm) portion of the anterior esophagus wall followed by cotton suture repair. Three months later stenosis were confirmed by esophagogram. Next, scar tissue formed was ressected followed by SIS patch placement. Two months after the procedure new esophagogram was performed. Esophageal width was measured at the proximal and middle third portions, before and after the SIS patch placement. Animals were sacrified, and esophagus were sent for histological examinations. RESULTS: No fistula or infection were found. Microscopic analysis revealed complete mucous membrane regeneration, discrete inflamatory reaction and moderate vascular proliferation. Esophageal width was enlarged in 70% of studied animals (43% ± 13%) (p = 0,2135). Proximal measurement increased from 0,76cm to 0,95cm; no significantly change occurred at the medial portion. CONCLUSION: SIS proved to be reliable graft reapair for canine esophageal stenotic lesions. It integrates to the esophageal wall and adequately replaces it.

Purpose: The aim of the present study was to evaluate the biocompatibility of small intestinesubmucosa (SIS) in the reconstruction of the ureter in swine.Materials and Methods: An experimental study was performed in 10 half-breed pigs weighingbetween 20 and 30 K, in which a previously prepared segment of SIS measuring approximately 2.0cm was implanted in the upper third part of the right ureter.Results: Of the 10 operated animals, one died 14 days after the surgery due to a dehiscenceon the suture line of the implanted graft. The remaining 9 animals were submitted to ultrasoundexamination of the urinary tract and were sacrificed on the 40th postoperative day. The macroscopicevaluation showed no calculus, incrustation, fistula, abscesses or adhesions in the ureters with thegraft. Microscopic evaluation with hematoxylin-eosin and Sirius red showed in the experimental area(graft) the presence of urothelium in 100% of the cases, collagen in 100% of the cases, and smoothmuscle layer in 87.5% of the animals. In the area adjacent to the graft (proximal and distal), weobserved 92.86% of urothelium, 42.86% of collagen and 71.43% of smooth muscle. In the contralateralureter, it was found 100% of urothelium and smooth muscle and just 11.11% of collagen. Themicroscopic analysis of the kidneys whose ureters received the graft of SIS evidenced congestion in55.55%, pelvic edema in 66.66% and interstitial nephritis in 77.78%. Hydronephrosis was present in33.33% and chronic pyelonephritis in 44%. Only 1 animal presented total absence of glomerulus inthe renal parenchyma.Conclusion: The SIS graft behaved as a biological tissue support, allowing the regenerationof the urothelium and smooth muscle grow, despite of chronic inflammatory process.Key words : small intestine; submucosa; ureter; graft; swineInt Braz J Urol. 2004; 30: 327-35