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Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes.

Background: The best site for splenic implant was not defined, mainly evaluating the functionality of the implant. Aim: To evaluate the effects of autogenous splenic implantation on the subcutaneous tissue in the survival of splenectomized rats. Method: Twenty-one randomly assigned rats were studied in three groups (n=7): group 1 - manipulation of the abdominal cavity and preservation of the spleen; group 2 - total splenectomy; group 3 - splenectomy and implant of the tissue removed in the subcutaneous. The animals were followed for 90 days postoperatively. Results: There was a higher mortality in groups 2 (p=0.0072) and 3 (p=0.0172) in relation to group 1. There was no difference between groups 2 and 3 (p=0.9817). Conclusion: The splenic implant in the subcutaneous is ineffective in the survival of rats submitted to splenectomy. RESUMO Racional: O melhor sítio para implante esplênico não foi definido, principalmente avaliando a funcionalidade do implante. Objetivo: Avaliar os efeitos do implante esplênico autógeno subcutâneo na sobrevida de ratos esplenectomizados. Métodos: Foram estudados 21 ratos alocados aleatoriamente em três grupos (n=7): grupo 1 - manipulação da cavidade abdominal e preservação do baço; grupo 2 - esplenectomia total; grupo 3 - esplenectomia e implante do tecido retirado no subcutâneo. Os animais foram acompanhados por 90 dias pós-operatórios. Resultados: Houve mortalidade maior nos grupos 2 (p=0,0072) e 3 (p=0,0172) em relação ao grupo 1. Não houve diferença entre os grupos 2 e 3 (p=0,9817). Conclusão: O implante esplênico no subcutâneo é ineficaz na sobrevida de ratos submetidos à esplenectomia.

Resumo Anastomoses vasculares são procedimentos comuns realizados por grande parte dos cirurgiões e cujo treinamento ocorre principalmente em seres humanos, contrariando os princípios éticos vigentes. Esse fato se deve, sobretudo, à carência e ao alto custo relacionados aos atuais modelos de treinamento. Assim, este estudo visa avaliar a viabilidade de três vegetais para a realização de anastomoses vasculares. Foram utilizadas cinco unidades de cebolinha, vagem e feijão-verde. Em cada uma tentou-se realizar uma anastomose término-terminal. Conseguiu-se a realização da anastomose apenas na vagem e no feijão-verde. Contudo, por apresentar uma menor espessura, o feijão-verde assemelhou-se mais aos vasos humanos. Abstract Vascular anastomoses are common procedures and are performed by most surgeons. Training is primarily conducted in human beings, which violates current ethical principles. This is because current training models are expensive and in short supply. This study was designed to investigate the feasibility of three vegetable models of vascular anastomosis. Five units each of scallions, green beans, and yardlong beans were used. An end-to-end anastomosis was attempted with each specimen. Anastomoses were only successful in green beans and yardlong beans. Since they are narrower, the yardlong beans are the most similar to human vessels.

The right femoral vessels of 80 rats were identified and dissected. External lengths and diameters of femoral arteries and femoral veins were measured using either a microscope or a video magnification system. Findings were correlated to animals’ weights. Mean length was 14.33 mm for both femoral arteries and femoral veins, mean diameter of arteries was 0.65 mm and diameter of veins was 0.81 mm. In our sample, rats’ body weights were only correlated with the diameter of their femoral veins. Resumo Os vasos femorais de 80 ratos foram identificados e dissecados. O comprimento e o diâmetro externo da artéria e da veia femoral foram mensurados com o auxílio de um microscópio e um sistema de magnificação por vídeo. Esses parâmetros foram correlacionados com o peso do animal. O comprimento de ambos os vasos femorais foi de 14,33 mm, e a média do diâmetro das artérias foi de 0,65 mm, e das veias, de 0,81 mm. Na nossa amostra, o peso dos animais se correlacionou apenas com o diâmetro da veia femoral.

Background: Mesenteric ischemia is a challenging diagnosis. Delay in diagnosis can lead to extent bowel necrosis and poor outcomes. Ischemia and reperfusion syndrome plays an important role in this scenario. Aim: To access effects of different post-conditioning cycles on mesenteric ischemia-reperfusion syndrome. Method: Twenty-five rats were assigned into five groups: Sham, used to establish normal parameters; control group, submitted to mesenteric ischemia for 30 min; in groups GP3, GP1 and GP30, ischemia was followed by post-conditioning protocol, which consisted of 1 cycle of 3 min (GP3), 3 cycles of 1 min (GP1) or 6 cycles of 30 s (GP30), respectively. Ileum samples were harvested after one hour of reperfusion. Intestinal mucosal injury was evaluated through histopathological analysis. Results: The average of mesenteric injury degree was 0 in the sham group, 3.6 in the control group, 3.4 in GP3, 3.2 in GP1, and 3.0 in GP30; villous length average was 161.59 in sham group, 136.27 in control group, 135.89 in GP3, 129.46 in GP1, and 135.18 in GP30. Was found significant difference between sham and other groups (p

Dentre os conceitos relacionados à terminalidade da vida, encontram-se a distanásia e a ortotanásia. Distanásia significa a obstinação terapêutica para adiar a morte iminente. Ortotanásia significa morte em seu processo natural, não prolongando o tratamento. Este estudo objetivou analisar a percepção de familiares de pacientes internados acerca da ortotanásia e distanásia, avaliando a alternativa mais aceita. Trata-se de estudo transversal e observacional, no qual foram entrevistados 190 familiares por meio de questionário padronizado contendo perguntas sobre aspectos sociais e conhecimento da temática. A maioria (64,2%) manifestou preferência pela distanásia como conduta para seu familiar. Entre 122 participantes que desconheciam o significado de "estado terminal", 85,2% optariam pela distanásia. Porém, entre os que conheciam o significado, 70,9% optariam pela ortotanásia. O estudo indica a necessidade de trazer o tema para discussão da sociedade, sensibilizando-a a entender implicações individuais e coletivas do prolongamento da vida em situação de sofrimento. Entre los conceptos relacionados con el fin de la vida, están la distanasia y la ortotanasia. Distanasia significa la obtinación terapéutica para postergar la muerte inminente. Ortotanasia significa muerte en su proceso natural, sin prolongar el tratamiento. El objetivo de este estudio fue analizar la percepción de los familiares de pacientes hospitalizados sobre la ortotanasia y la distanasia, evaluando la alternativa más aceptada. En este estudio observacional y transversal 190 familiares fueron entrevistados mediante un cuestionario estandarizado que contenía preguntas sobre los aspectos sociales y de conocimientos sobre el tema. La mayoría (64,2%) manifestó su preferencia por la distanasia como conducta para su familiar. De los 122 participantes que no conocían el significado de "estado terminal", el 85,2% optaría por la distanasia. No obstante, entre los que conocían el significado, el 70,9% optarían por la ortotanasia. El estudio indica la necesidad de plantear el tema para discusión de la sociedad, sensibilizándola a entender implicaciones individuales y colectivas de la prolongación de la vida en situación de sufrimiento. Futility and orthotanasia are among the concepts related to the terminality life. Futility means therapeutic obstinacy to delay imminent death. Orthothanasia means death in its natural process, not prolonging treatment. The aim of this study was to analyze the perception of patients` family members in private general hospital on orthotanasia and futility, assessing which the most widely accepted alternative is. This was a cross-sectional, observational study, in which 190 families were interviewed using a standardized questionnaire containing questions about social aspects and knowledge on the subject. Most respondents (64.2 %) opted for the realization of futility as a conduct for their relative. Of the 122 participants who did not know the meaning of "terminal condition", 85.9% would choose futility. However, among those who knew what they meant, 70,9% would choose orthotanasia. The study indicates that this topic needs to be discussed by society, encouraging them to understand the individual and collective implications of life prolongations when suffering.