ABSTRACT Objective To assess testicular volumes and sexual maturation in patients with testicular torsion. Methods A retrospective analysis of consecutively treated patients with testicular torsion between 2016 and 2018. Age, pubic hair staging (Tanner), and by ultrasonography, volume of the unaffected testis (in cubic centimeters) were evaluated either immediately before surgery or at the first postoperative visit. Patients with previous testicular disease, such as cryptorchidism, or with no records of testicular volume were excluded. The analysis included descriptive statistics and Bayesian regression. Results We treated 149 patients during the study period, and 141 (94.6%, median age 17.3 years) met the inclusion criteria. Median testicular volume was 13.0cm3 (interquartile range of 10.5-15.2), with similar right and left volumes (12.9cm3versus 13.3cm3; p=0.94). Sixty-five (46.1%) patients were Tanner stage IV, 17 (12.1%) stage III, and 59 (41.8%) stage V. Conclusion In this study, we were able to estimate volumes of testicular torsion, which aggregated around late puberty values (13.0cm3 for the whole dataset, 12.2cm3 for patients <25 years), suggesting that testicular hypermobility, due to congenital anatomical abnormalities, remains quiescent until the organ reaches a critical volume, after which torsion becomes possible. These findings provide a tentative explanation for the disease’s age distribution.

OBJETIVO: Avaliar os efeitos do hemissulfato de S-metilisotiouréia (SMT) na cicatrização de anastomoses colônicas em ratos no terceiro, sétimo e 14° dia de pós-operatório (DPO). MÉTODOS: Sessenta ratos Wistar foram distribuídos em dois grupos: experimental (E) e controle (C), com 30 animais cada. No grupo experimental foi administrado SMT 50mg/kg/dose, intraperitoneal a cada 12 horas por 72 horas. O grupo controle recebeu NaCl a 0,9%. Os ratos foram subdivididos em grupos de 10 para eutanásia no terceiro, sétimo e 14° DPO. Avaliou-se a evolução clínica e o peso dos animais, a resistência tênsil e histopatologia da anastomose, e a dosagem de nitrito/nitrato no soro. RESULTADOS: Houve mais neoformação vascular (p=0,006) e de granulação (p=0,002) no grupo E3, e maior infiltração de mononucleares no grupo C3 (p=0,041). Houve também mais edema no grupo C14 (p=0,008). Não houve diferença estatisticamente significativa na resistência tênsil, a dosagem de nitrito / nitrato, e os restantes parâmetros histopatológicos. CONCLUSÃO: A utilização do hemissulfato de S-metilisotiouréia acelerou a cicatrização das anastomoses colônicas, a melhoria ocorreu no terceiro DPO: verificou-se que a fase proliferativa da cicatrização foi acelerada. Não houve interferência na resistência tênsil das anastomoses.

PURPOSE: To evaluate the effects of S-methylisothiourea hemisulfate (SMT) on the healing of colonic anastomosis in rats. METHODS: Sixty rats Wistar were distributed into two groups of 30 animals: experimental (E) and control C). The animals of experimental group received intraperitoneal SMT at 50mg/kg/dose every 12 hours for 72 hours. The control group received intraperitoneal saline at the same volume of SMT. The rats were subdivided into subgroups groups of 10 for euthanasia on the third, seventh, and 14th postoperative days (POD). We evaluated clinical and weight evolution, breaking strength and histopathology; also, a blood sample was collected for serum dosage of nitrite/nitrate. RESULTS: There was more vascular neoformation (p=0.006) and granulation (p=0.002) in the E3 group, and more mononuclear infiltrates in the C3 group (p=0.041). There was also more edema in the C14 group (p=0.008). There was no statistically significant difference in breaking strength, nitrite/nitrate dosage, and the remaining histopathological parameters. CONCLUSION: The use of S-methylisothiourea hemisulfate improved the healing of colonic anastomosis in rats on the third postoperative day by accelerating the proliferative stage of healing, but without interfering with the breaking strength of the anastomosis.

RACIONAL: O megaesôfago chagásico é disfunção da motilidade esofágica de caráter progressivo. Seus principais sintomas são disfagia, regurgitação e perda de peso. A cardiomiotomia associada à fundoplicatura é usada como tratamento para o megaesôfago não avançado há algumas décadas. OBJETIVO: Avaliar os resultados obtidos com a cardiomiotomia associada à fundoplicatura por videolaparoscopia para o tratamento do megaesôfago não avançado. MÉTODO: Estudo retrospectivo com análise dos resultados obtidos com essa operação para tratamento do megaesôfago graus I e II. Avaliou-se perda ponderal, tempo e intensidade dos sintomas, tempo operatório, taxa de conversão, índice de complicações, tempo de internação. RESULTADOS: Foram operados 68 pacientes, sendo 34 homens. A maioria (42%) apresentava sintomas intensos. O tempo médio de sintomas foi de 9,27 anos. A perda ponderal média foi de 5,1 kg. Sorologia para Chagas foi positiva em 88,13%. O tempo médio de operação foi de 190 minutos. Houve uma conversão para laparotomia. A mediana do tempo de internação foi de três dias. A taxa de complicações foi de 4,4%. A melhora dos sintomas foi observada em 92% dos pacientes. CONCLUSÃO: O tratamento videolaparoscópico do megaesôfago não-avançado pela cadiomiotomia associada à fundoplicatura mostrou-se método seguro e eficaz. Apresenta baixo índice de complicações e bons resultados no seguimento a curto prazo.

BACKGROUND: The chagasic megaesophagus is progressive esophageal motility dysfunction. Its main symptoms are dysphagia, regurgitation and weight loss. Cardiomyotomy associated with fundoplication is used as treatment for advanced megaesophagus since decades ago. AIM: To evaluate the results obtained with cardiomyotomy associated with laparoscopic fundoplication for the treatment of non-advanced megaesophagus. METHOD: A retrospective study with analysis of the results obtained with this operation for the treatment of megaesophagus grade I and II was done. Were evaluated the weight loss, time and intensity of symptoms, operative time, conversion rate, complication rate, length of hospitalization. RESULTS: Were operated 68 patients, 34 men. The majority (42%) had severe symptoms. The average length of symptoms was 9.27 years. The mean weight loss was 5.1 kg. Chagas serology was positive in 88.13%. The average operation time was 190 minutes. There was one conversion to laparotomy. The median length of hospital stay was three days. The complication rate was 4.4%. The improvement in symptoms was observed in 92% of patients. CONCLUSION: The laparoscopic treatment of non-advanced megaesophagus by cadiomiotomy associated with fundoplication was found to be safe and effective method. Has a low complication rate and good results in short follow-up.