Reopening of the gastroduodenal pylorus after its closure in rats. 2008

Jorge Miguel Schettino César, and Andy Petroianu, and Agostinho Pinto Gouvêa, and Dierre Roberto Alvin
Department of Surgery, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.

BACKGROUND Duodenal injury occurs in 3% to 12% of patients with abdominal trauma. The best procedure to treat major duodenal ruptures continues to be a challenge. The purpose of the present study was to analyze differences between the time of gastroduodenal pylorus reopening after its closure with different suture materials and to verify the influence of vagotomy on local tissue changes. METHODS Thirty rats were submitted to closure of the gastroduodenal pylorus and gastrojejunal anastomosis. The animals were divided into three groups (n = 10) according to the type of suture material used: plain catgut, polyglycolic acid, and polypropylene. Half of the animals in each group (n = 5) were also submitted to truncal vagotomy. Postoperative assessment included weekly abdominal X-ray following intragastric contrast injection until re-establishment of the gastroduodenal transit or for a maximum period of 4 wk. At the end of the follow-up period, the pyloric regions and the gastrojejunal anastomosis were removed for histological analysis. The groups were compared by the Kaplan-Meier test, with the level of significance set at P < 0.05. RESULTS The polypropylene suture maintained the pylorus closed for a longer period of time (36.3 +/- 11.6 d) (P < 0.05). No difference was observed between the polyglycolic acid suture (25.8 +/- 14.2 d) and the plain catgut suture (18.7 +/- 10.2 d). Vagotomy did not influence the time of pyloric reopening, but was associated with a less intense gastric inflammatory reaction. CONCLUSIONS The nonabsorbable suture was the most adequate for exclusion of pyloric transit. Vagotomy had no influence on the time of pyloric reopening but reduced gastric inflammation.

UI MeSH Term Description Entries
D007583 Jejunum The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum. Jejunums
D011100 Polyglycolic Acid A biocompatible polymer used as a surgical suture material. Polyglycolide,Biofix,Dexon (Polyester),Dexon-S,Dexon S,DexonS
D011126 Polypropylenes Propylene or propene polymers. Thermoplastics that can be extruded into fibers, films or solid forms. They are used as a copolymer in plastics, especially polyethylene. The fibers are used for fabrics, filters and surgical sutures. Propene Polymers,Propylene Polymers,Hostalen,Marlex,Marlex Polypropylene,Polypro,Polypropylene,Prolene,Polymers, Propene,Polymers, Propylene,Polypropylene, Marlex
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011708 Pylorus The region of the STOMACH at the junction with the DUODENUM. It is marked by the thickening of circular muscle layers forming the pyloric sphincter to control the opening and closure of the lumen. Pyloric Sphincter,Pyloric Sphincters,Sphincter, Pyloric,Sphincters, Pyloric
D002398 Catgut Sterile collagen strands obtained from healthy mammals. They are used as absorbable surgical ligatures and are frequently impregnated with chromium or silver for increased strength. They tend to cause tissue reaction. Catguts
D004386 Duodenum The shortest and widest portion of the SMALL INTESTINE adjacent to the PYLORUS of the STOMACH. It is named for having the length equal to about the width of 12 fingers. Duodenums
D005744 Gastric Acid Hydrochloric acid present in GASTRIC JUICE. Hydrochloric Acid, Gastric,Acids, Gastric,Acids, Gastric Hydrochloric,Gastric Acids,Gastric Hydrochloric Acid,Gastric Hydrochloric Acids,Hydrochloric Acids, Gastric
D000714 Anastomosis, Surgical Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side. Surgical Anastomosis,Anastomoses, Surgical,Surgical Anastomoses
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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