Estudo comparativo com diferentes números de pontes na neurorrafia término-lateral em ratos
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Data
2010-06-22
Autores
Franco, Rodrigo de Gouveia [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
A neurorrafia término-lateral é técnica consagrada em casos onde não há coto proximal após lesão de nervo periférico. O coto distal pode ser suturado na lateral de qualquer nervo ou receber enxerto de nervo unindo a sua face lateral à face lateral de outro nervo, atuando como uma ponte. O número de enxertos em ponte poderia aumentar o resultado da reinervação muscular? Para responder esta pergunta realizou-se este trabalho. Foram operados 100 ratos Wistar divididos em cinco grupos experimentais com 20 animais cada. O GN (grupo controle de normalidade) não sofreu nenhum procedimento. No GD (grupo controle de desnervação) o nervo fibular foi seccionado e ambos os cotos foram suturados em músculos adjacentes e distantes entre si. O G1 recebeu um enxerto (ponte de nervo sural) tendo uma de suas extremidades suturadas na face lateral do nervo tibial (NT) e a outra na face lateral do segmento distal do nervo fibular (NF). No G2 e no G3 foram realizados os mesmos procedimentos que no G1. O G3 com 3 e o G2 com 2 enxertos. Em todos os casos foram utilizadas neurorrafias término-laterais (NTL) tipo “embracing” sem retirada de janela de epineuro. Os animais foram sacrificados após 120 dias. Foram realizados testes de marcha (“Walking-tracks”) e testes eletrofisiológicos além de aferição da massa dos animais e dos músculos tibiais craniais direitos (MTCD). Segmentos de nervo de interesse também foram coletados. Foram realizadas análises histomorfométricas das fibras musculares e nervosas. Após análise global dos atributos do MTCD como massa, IMM (índice de massa muscular), área, menor e maior diâmetro das fibras musculares, número de fibras por campo, análise funcional (IFC –índice funcional do ciático), análise eletrofisiológica e análise morfométrica dos segmentos nervosos mais importantes, concluímos que não houve benefício com o aumento do número de pontes
The end-to-side neurorrhaphy technique is enshrined in cases where there is no proximal stump after peripheral nerve injury. The distal end can be sutured to the side of any nerve. We also can use a nerve graft joining the lateral face of the distal end to the lateral face of another nerve, serving as a bridge. The number of bridges would increase the outcome of muscle reinnervation? To answer this question took place this work. Were operated on 100 rats divided into five groups with 20 animals each. GN (normal control group) received no further procedure. For GD (control group denervation) the peroneal nerve was transected and both stumps were sutured to adjacent muscles and far between. G1 received one graft (sural nerve bridge) having one end stitched on the side of the tibial nerve (NT) and the other on the side of the distal segment of the peroneal nerve (NF). In G2 and G3 were performed the same procedures as in G1. G3 with three and G2 with two grafts. In all cases were used end-to-side neurorraphies (NTL) performed as embracing without removing epineural window. The animals were sacrificed after 120 days. We performed tests of gait (Walking-tracks) and electrophysiological tests in addition to measuring the mass of animals and also the mass of cranial tibial muscles (MTCD). Nerve segments of interest were also collected. We performed histomorphometric analysis of muscle fibers and nerves. After comprehensive analysis of attributes such as mass MTCD, IMM (body mass index), area, smaller and larger diameter of muscle fibers, number of fibers per field, functional analysis (IFC, sciatic functional index), electrophysiological and morphometric analysis of the most important nerve segments, we conclude that there was no benefit to increasing the number of bridges
The end-to-side neurorrhaphy technique is enshrined in cases where there is no proximal stump after peripheral nerve injury. The distal end can be sutured to the side of any nerve. We also can use a nerve graft joining the lateral face of the distal end to the lateral face of another nerve, serving as a bridge. The number of bridges would increase the outcome of muscle reinnervation? To answer this question took place this work. Were operated on 100 rats divided into five groups with 20 animals each. GN (normal control group) received no further procedure. For GD (control group denervation) the peroneal nerve was transected and both stumps were sutured to adjacent muscles and far between. G1 received one graft (sural nerve bridge) having one end stitched on the side of the tibial nerve (NT) and the other on the side of the distal segment of the peroneal nerve (NF). In G2 and G3 were performed the same procedures as in G1. G3 with three and G2 with two grafts. In all cases were used end-to-side neurorraphies (NTL) performed as embracing without removing epineural window. The animals were sacrificed after 120 days. We performed tests of gait (Walking-tracks) and electrophysiological tests in addition to measuring the mass of animals and also the mass of cranial tibial muscles (MTCD). Nerve segments of interest were also collected. We performed histomorphometric analysis of muscle fibers and nerves. After comprehensive analysis of attributes such as mass MTCD, IMM (body mass index), area, smaller and larger diameter of muscle fibers, number of fibers per field, functional analysis (IFC, sciatic functional index), electrophysiological and morphometric analysis of the most important nerve segments, we conclude that there was no benefit to increasing the number of bridges
Descrição
Palavras-chave
Nervos - Enxerto, Neurorrafia, Rats, Peripheral nerve
Como citar
FRANCO, Rodrigo de Gouveia. Estudo comparativo com diferentes números de pontes na neurorrafia término-lateral em ratos. 2010. 112 f. +. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2010.