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    Anastomose carotídea usando laser diodo de diferentes comprimentos de onda e a avaliação da resistência da parede em suínos.
    (Universidade Federal de São Paulo (UNIFESP), 2018-10-25) Andrade, Luciane Basilio Alledi [UNIFESP]; Plapler, Helio [UNIFESP]; Fagundes, Djalma José; http://lattes.cnpq.br/8694381071456316; http://lattes.cnpq.br/2871630525937037; http://lattes.cnpq.br/3022078938154501; Universidade Federal de São Paulo (UNIFESP)
    Objective: due to the advantages of LAVA (less occurence of miointimal hyperplasia with better hemodynamic evolution, shorter surgical time, absence of diameter incompatibility, absence of anaphylaxis, easy execution) the evaluation of the ideal diode laser wavelength to perform these anastomosis without solder is a great advance in the surgical practice. Method: End-to-end anastomosis was performed on the common carotid arteries of swines, bilaterally, using diode lasers by the wavelengths: 808 nm (n=16), 980 nm (n=16), 1470 nm (n=16) and 1908 nm (n=16) with the same parameters (CW, spot size=2mm, P≅5,1W, t=26s, E= 132,6J, I= 164,51 W/cm2, F= 4277,4 J/cm2). Following, the occurrence of bleeding was verified. When the anastomosis did not bleed a mechanical resistance test was performed. Results: In group 808 nm, there was no welding of the vessels. In group 1908 nm, carbonization of all arterial edges was observed. In groups 980 nm and 1470 nm, the anastomosis results were satisfactory. In group 980 nm, 50% of the anastomosis cases exhibited bleeding and the medium leaking point pressure was 155 ± 56,3 mmHg. In group 1470 nm, 31,3% of the anastomosis cases exhibited bleeding and the medium leaking point pressure was 179,1 ± 37,0 mmHg. There was no statistically significant difference in leaking point pressures between the groups 1470 nm and 980 nm (p=0,094). Based on the physiological blood pressure levels for group 980 nm, the bleeding risk was higher and the survival probability was lower than that of group 1470 nm (p=0,022). Conclusions: The best results for anastomosis in carotid arteries without solder were achieved with 980 nm and 1470 nm. The higher survival probability with lower bleeding risk was obtained by 1470nm anastomosis on carotid arteries.
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    Comparative results of gastric submucosal injection with hydroxypropyl methylcellulose, carboxymethylcellulose and normal saline solution in a porcine model
    (Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2010-06-01) Lenz, Luciano [UNIFESP]; Di Sena, Veruska [UNIFESP]; Nakao, Frank S. [UNIFESP]; Andrade, Gustavo Paulo de [UNIFESP]; Rohr, Maria Rachel da Silveira [UNIFESP]; Ferrari, Angelo Paulo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT: Endoscopic mucosal resection is an established modality for excision of sessile lesions in the gastrointestinal tract. Submucosal fluid injection creates a cushion and may prevent thermal injury and perforation. OBJECTIVES: This blind study investigated the performance of three different solutions to create submucosal fluid cushions in porcine stomach. METHODS: Three solutions were injected in the stomach of nine pigs BR1: normal saline solution, carboxymethylcellulose 0.5% and hydroxypropyl methylcellulose 0.25%. In each pig, submucosal injections with 6 mL per test-solution were performed. One drop of methylene blue was added to all injections for better visualization. The time for the bleb to disappear was recorded. RESULTS: The overall median time of visible submucosal cushion was 37 minutes (range 12-60 min) for hydroxypropyl methylcellulose, 31 minutes for carboxymethylcellulose (range 10-43 min) and 19 minutes for normal saline solution (range 8-37 min). There was no statistically significant difference neither between normal saline solution and carboxymethylcellulose (P = 0.146) nor carboxymethylcellulose and hydroxypropyl methylcellulose (P = 0.119) but the median duration of hydroxypropyl methylcellulose was significantly longer than normal saline solution (P = 0.039). CONCLUSIONS: The length of hydroxypropyl methylcellulose submucosal fluid cushion is longer in comparison with normal saline solution. The median time for carboxymethylcellulose was not longer than normal saline solution. Hydroxypropyl methylcellulose, in the concentration of 0.25%, may be a durable alternative for submucosal injection.