Avaliação macroscópica, enzimática, histopatológica e bacteriológica do fígado após colecistectomia laparoscópica em coelhos: comparação entre ligasure e eletrocautério bipolar maryland
Carregando...
Data
2022-05-18
Autores
Vera, María Camila Maldonado [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Universidade Estadual Paulista (Unesp)
Resumo
RESUMO -Objetivo: Comparar os resultados do uso do dispositivo selante de vaso (EBVS-LigaSureTM MaryLand®) versus dissecção eletrocirúrgica (Bipolar Maryland) para dissecção da vesícula biliar (VB) da fossa hepática em colecistectomia laparoscópica (CL) em coelhos, além de correlacionar achados macroscópicos, histopatológicos e bacteriológicos, complicações cirúrgicas e análises laboratoriais Material e métodos: Foram utilizados 20 coelhos, distribuídos em dois grupos. Grupo GLL usando dispositivo selante de vasos (n = 10) e grupo GLE usando eletrocirúrgico bipolar (n = 10). O tempo total de cirurgia e dissecção de VB foram mensurados, e as complicações foram tabuladas. Os parâmetros enzimáticos e bioquímicos da função hepática foram realizados nos períodos pré e pós-operatório no terceiro, sétimo e décimo quinto dia para posterior comparação. Alterações abdominais macroscópicas foram verificadas 15 dias após a cirurgia por meio de necropsia, as amostras de fígado coletadas foram submetidas à avaliação histopatológica e bacteriológica. Resultados: As técnicas de GLL e GLE não apresentaram diferenças nos tempos cirúrgicos, achados na necropsia, porcentagem de complicações intraoperatórias, de crescimento bacteriano por cultura e de complicações detectadas por ultrassom; causou valores semelhantes de GGT, AST, Bilirrubina Total, Bilirrubina Direta e fibrinogênio em todos os dias de avaliação. No entanto, quando a técnica GLL foi utilizada, 15 dias após a cirurgia, observou-se maior concentração de fosfatase alcalina quando comparada ao GLE. Por outro lado, o GLE resultou em concentração maior de ALT aos três dias quando comparado ao GLL. As técnicas não mostraram diferenças no escore de células gigantes, necrose e fibrose durante a histopatologia, e porcentagem semelhante de presença de siderófago. Conclusão: Não foram encontradas diferenças estatísticas significativas entre a utilização do EBVS-LigaSureTM MaryLand® e o Bipolar Maryland em termos de alterações nas variáveis analisadas; ambos os dispositivos são igualmente seguros e eficazes em CL em coelhos.
to compare the results of using a vessel sealing device (EBVS-LigaSureTM MaryLand®) versus electrosurgical dissection (Bipolar Maryland) for dissection of the gallbladder (VB) of the hepatic fossa in laparoscopic cholecystectomy (LC) in rabbits, in addition to correlating macroscopic, histopathological and bacteriological findings, surgical complications and laboratory analysis. Patients & methods: 20 rabbits were used, divided into two groups. GLL group using a vessel sealing device (n = 10) and GLE group using bipolar electrosurgical (n = 10). The total time of surgery and VB dissection were measured, and complications were tabulated. The enzymatic and biochemical parameters of liver function were performed in the pre- and postoperative periods on the third, seventh and fifteenth day for later comparison. Macroscopic abdominal alterations were verified 15 days after surgery through necropsy, the collected liver samples were submitted to histopathological and bacteriological evaluation. Results: The GLL and GLE techniques showed no differences in surgical times, necropsy findings, percentage of intraoperative complications, bacterial growth by culture and complications detected by ultrasound; caused similar values of GGT, AST, Total Bilirubin, Direct Bilirubin and fibrinogen on all evaluation days. However, when the GLL technique was used, 15 days after surgery, a higher concentration of alkaline phosphatase was observed when compared to GLE. On the other hand, GLE resulted in a higher concentration of ALT at three days when compared to GLL. The techniques showed no differences in giant cell score, necrosis and fibrosis during histopathology, and similar percentage of siderophage presence. Conclusion: No statistically significant differences were found between the use of the EBVS-LigaSureTM MaryLand® and the Bipolar Maryland in terms of changes in the analyzed variables; both devices are equally safe and effective in CL in rabbits.
to compare the results of using a vessel sealing device (EBVS-LigaSureTM MaryLand®) versus electrosurgical dissection (Bipolar Maryland) for dissection of the gallbladder (VB) of the hepatic fossa in laparoscopic cholecystectomy (LC) in rabbits, in addition to correlating macroscopic, histopathological and bacteriological findings, surgical complications and laboratory analysis. Patients & methods: 20 rabbits were used, divided into two groups. GLL group using a vessel sealing device (n = 10) and GLE group using bipolar electrosurgical (n = 10). The total time of surgery and VB dissection were measured, and complications were tabulated. The enzymatic and biochemical parameters of liver function were performed in the pre- and postoperative periods on the third, seventh and fifteenth day for later comparison. Macroscopic abdominal alterations were verified 15 days after surgery through necropsy, the collected liver samples were submitted to histopathological and bacteriological evaluation. Results: The GLL and GLE techniques showed no differences in surgical times, necropsy findings, percentage of intraoperative complications, bacterial growth by culture and complications detected by ultrasound; caused similar values of GGT, AST, Total Bilirubin, Direct Bilirubin and fibrinogen on all evaluation days. However, when the GLL technique was used, 15 days after surgery, a higher concentration of alkaline phosphatase was observed when compared to GLE. On the other hand, GLE resulted in a higher concentration of ALT at three days when compared to GLL. The techniques showed no differences in giant cell score, necrosis and fibrosis during histopathology, and similar percentage of siderophage presence. Conclusion: No statistically significant differences were found between the use of the EBVS-LigaSureTM MaryLand® and the Bipolar Maryland in terms of changes in the analyzed variables; both devices are equally safe and effective in CL in rabbits.
Descrição
Palavras-chave
Aderências, Dissecção ultrassônica, Eletrocirurgia bipolar, Laparoscopia, Lesões teciduais, Vesícula biliar, Colecistectomia