Biomedical subjects

D García-Olmo

Publications and source records attributed to D García-Olmo.

25 records · Page 2Linked to original sources

PubMed1996

Effects of an intra-abdominal latex (drain-like) tube on anastomotic resistance and adhesion formation in a rat model.

PURPOSE: Aim of the present study was to determine effect of a latex drain on colonic resistance and its relation to adhesion phenomena. METHODS: Forty Sprague-Dawley rats were divided into two groups (n = 20): Group 1, simple colonic anastomosis; and Group 2, colonic anastomosis with drain "ad latum." Rats were sacrificed four days after surgery, and adhesions were evaluated. Segment containing anastomosis was removed, and bursting pressure was determined. RESULTS: General adhesion scores in Group 2 were higher than in Group 1 (P = 0.002). Score for adhesions to anastomotic line in Group 1 was higher than in Group 2 (P = 0.016). Bursting pressure was significantly lower in Group 2 (Group 1, 67.90 +/- 31.39 mmHg; Group 2, 46.95 +/-1 29.69 mmHg; P = 0.034). In all cases, leakage of dye was observed at the anastomotic line. A multiple regression test was applied to both groups (40 cases), taking bursting pressure as the dependent variable and other parameters as independent variables. A strong relationship appeared to exist between anastomotic resistance and fraction of anastomotic line that was covered by the neighboring organ (P < 0.001). CONCLUSIONS: Placing a latex drain near a colonic anastomosis is associated with local inhibition of spontaneous adhesions to anastomotic line and, therefore, to significantly decreased resistance.

Anastomosis, Surgical↗

PubMed1996

Postoperative gangrenous peritonitis after laparoscopic cholecystectomy: a new complication for a new technique.

We report a case of anaerobic peritonitis with bowel emphysema, but no hollow organ perforations, following gallbladder removal for acute acalculous cholecystitis using a laparoscopic procedure in a diabetic patient. Management consisted of profuse peritoneal irrigation and zipper laparostomy. After a long postoperative period, the patient recovered without sequelae. The patient suffered typical acute cholecystitis with empyema and a diabetic status; anaerobial flora is frequent in these cases. The patient was operated on by means of a closed technique without contact with either air or oxygen. Moreover, CO2 injection into the peritoneal cavity with this technique, along with gallbladder rupture, created an ideal medium for anaerobial growth. We suggest that acalculous cholecystitis in diabetic patients could represent a contraindication for laparoscopic cholecystectomy; alternatively, open cholecystectomy should at least be considered when gallbladder rupture occurs during laparoscopy.

Cholecystectomy, Laparoscopic↗

PubMed1994

Correlation between pressure changes and solid transport in the human left colon.

A study was made to correlate colonic pressure changes and solid transport in six volunteers with a left terminal colostomy. A minimally deformable solid (sham fecaloma) 2 cm in diameter was placed in the colonic lumen together with three perfusion catheters connected to the exterior via a semi-rigid rod to record movement and pressure changes. The results obtained indicate the presence of two types of segmentary motor phenomena: those that cause displacement and those that do not. Both reflect synchronous pressure increments, although the Displacing Motor Phenomena exhibit an aborally-directed pressure gradient in contrast to the orally orientated gradient in Non-displacing Motor Phenomena (P = 0.003). The Displacing Motor Phenomena cause rapid exit of the solid from the colostomy, but with a short mean trajectory (4.2 cm). Thus, segmentary contractions may generate forward propulsion provided that aborally-directed pressure gradients occur. A slow aboral displacement also occurs during periods of motor quiescence. This may be explained by tonic contractions undetected by conventional manometry.

Catheterization↗

PubMedDate not supplied

Absence of a relationship between the increased survival of skin grafts provoked by additional spleen transplantation and the detection of donor chimeric cells in rats.

The goal of this study was to examine the relationship between the effects of spleen transplantation on the acceptance of a skin allograft from the same donor and the detection of donor chimerism in recipient tissues. Male Sprague-Dawley rats and female Wistar rats were used as donors and recipients, respectively. Four experimental groups were established: group C: only skin grafting was performed; group S: recipients were splenectomized before skin grafting; group 1: skin grafts were performed immediately after splenectomy of recipients and spleen transplantation, and group 2: splenectomy of the recipients and spleen grafting were performed 48 h before skin grafting. All animals were sacrificed 14 weeks after surgery. The rate of acceptance of skin grafts was significantly higher in animals that received both skin and spleen transplantations than in group C (p = 0.03) or in group S (p = 0.04). Detection of donor chimeric cells was significantly more frequent in rats after spleen transplantation than in group C (p = 0.03). However, the detection of chimeric cells was not related to the acceptance of skin grafts. To conclude, the beneficial effect of spleen auxiliary transplantation on allograft survival was not related to the detection of long-term chimerism in the recipient's tissues.

Animals↗

PubMedDate not supplied

Relationship between peritoneal adhesion phenomena and the experimental resistance of colonic anastomoses: influence of omentoplasty.

The repair processes that follow surgical injury constitute the physiopathological basis of peritoneal adhesion phenomena. The aim of the present study was to investigate the influence of the peritoneal adhesion process on the resistance of colonic anastomoses during the early postoperative period. Sixty Sprague-Dawley rats were divided into three groups (n = 20 each) according to procedure: transverse colon section and anastomosis (group 1); omentoplasty performed on the anastomosis (group 2), and thin latex sheeting covering the anastomosis (group 3). The rats were sacrificed 4 days after surgery and the adhesion evaluated. The segment containing the anastomosis was removed and the bursting pressure determined; the diameter and Laplace's law were used to calculate the bursting wall tension (BWT). The mean BWT in group 1 was 30.73 dyn. 10(3)/cm. In the multivariate analysis, adhesions to the anastomotic line were found to exert the greatest influence on the BWT (p = 0.005). The mean BWT of the anastomoses with adhesions affecting 100% of the circumference was greater than when at least part of the latter remained free (p = 0.006). In group 2 the BWT was 55.92 dyn. 10(3)/cm, i.e., greater than in group 1 overall (p = 0.005) and similar to those anastomoses in that group completely covered by adhesions (p = 0.017). Mean BWT in group 3 was 14.62 dyn. 10(3)/cm, i.e., lower than in either group 1 or 2 (p = 0.009 and 0.000, respectively). No differences were seen when comparing with group 1 segments in which the anastomotic line was not entirely covered. Adhesions to the anastomotic line exert a beneficial effect on colonic anastomotic resistance 4 days after surgery. Adhesion formation should therefore not be interfered with. An omentoplasty secures 100% coverage of the anastomotic line, and should thus be considered when performing high-risk colonic anastomoses.

Anastomosis, Surgical↗

PubMedDate not supplied

[The relation of the adhesion phenomenon and the experimental resistance of colonic anastomoses. The effect of epiploplasty].

INTRODUCTION: We made an experimental study of the influence of the peritoneal adherence process on the strength of colic anastomosis. METHOD: 60 rats, in three groups of 20. Group I, colic anastomosis; Group II, colic anastomosis with epipoplasty; Group III, colic anastomosis covered with plastic material. They were slaughtered on the fourth post-operative day and we assessed the adherence parameters, removing the segment with anastomosis and measuring its breakage strength. Laplace's Law was applied to calculate Wall Breakage Stress (WBS). RESULTS: Group I: The statistically most significant influence on WBS was that of adherences to the anastomotic line (p = 0.005). WBS measured in anastomosis with adherence on 100% of the circumference was greater than in those where some part remained to be covered (p = 0.006). Group II: mean WBS was higher than in Group I as a whole (p = 0.005) and similar to that of the anastomosis in this group 100% covered by adherences (p = 0.017). Group III: mean WBS was lower than that of Group I (p = 0.009) and Group II (p = 0.000). CONCLUSIONS: The beneficial effect was demonstrated of adherences to the anastomotic line on the strength of colic anastomosis so that this process should not, wherever possible, be obstructed. During an epiploplasty, 100% coverage must be ensured: this technique must therefore be considered to belong to the group of high-risk colic anastomoses.

Anastomosis, Surgical↗

PubMedDate not supplied

Role of immediate postoperative feeding on colonic anastomoses resistance. An experimental study in a rat model.

PURPOSE: This study was performed to investigate whether immediate postoperative feeding induced changes on colonic anastomoses resistance. On the other hand, results was compared with a hyoscine-induced deep paralytic ileus status. METHODS: Sixty-three Sprague-Dawley rats were divided into three groups: Group 1 (n = 20; colonic anastomosis + water "ad libitum" + 1 cc of saline solution subcutaneously, daily); Group 2 (n = 21; colonic anastomosis + water and standard rat chow "ad libitum" + 1 cc of saline solution subcutaneously, daily); and Group 3 (n = 22; colonic anastomosis + water "ad libitum" + 2 mg/100 g body weight hyoscine N-butylbromide in 1 cc subcutaneously, daily). Body weight, food intake and water consumption were recorded on a daily basis. Surviving rats (20 in each group) were sacrificed 4 days after surgery and adhesions were evaluated. Each segment containing an anastomosis was removed and the bursting pressure was determined; the diameter and Lapace's law were used to calculate Bursting wall tension (BWT). RESULTS: The cause of death during the early postoperative period was dehiscence in 2 cases (1 in Group 2 and 1 in Group 3). A rat died in Group 3 due to non-specific side effects. Weight loss was significantly lower and water consumption significantly higher in Group 2 (Food) than in others groups. BWT was lower in Group 2 than in the other groups (53.61 x 10(3) dynes/cm +/- 24.51 x 10(3) dynes/cm in Group 1, 48.94 x 10(3) dynes/cm +/- 18.53 x 10(3) dynes/cm in Group 2 and 65.09 x 10(3) dynes/cm +/- 28.59 x 10(3) dynes/cm in Group 3). Nevertheless only comparison between Group 2 (Food) and Group 3 (Hyoscine) showed statistically significant difference (p = 0.03). In all cases leakage of dye was observed at the anastomotic line. General adhesion scores in Group 2 (Food Intake) were similar than Group 1 (Water only) and higher than in Group 3 (Hyoscine) (p = 0.036).

Anastomosis, Surgical↗