Abstract Introduction Anal intraepithelial neoplasia (AIN) is a premalignant lesion of the anal canal associated with HPV, with a higher prevalence in immunosuppressed individuals. Patients with inflammatory bowel disease (IBD) are at potential risk for their development, due to the use of immunosuppressants and certain characteristics of the disease. Method This is a prospective, cross-sectional, and interventional study that included 53 patients with IBD treated at a tertiary outpatient clinic, who underwent anal smear for cytology in order to assess the prevalence of AIN and associated risk factors. Results Forty-eight samples were negative for dysplasia and 2 were positive (4%). Both positive samples occurred in women, with Crohn’s disease (CD), who were immunosuppressed and had a history of receptive anal intercourse. Discussion The prevalence of anal dysplasia in IBD patients in this study is similar to that described in low-risk populations. Literature data are scarce and conflicting and there is no evidence to recommend screening with routine anal cytology in patients with IBD. Female gender, history of receptive anal intercourse, immunosuppression and CD seem to be risk factors.

OBJETIVO: Correlacionar a dosagem sérica pré-operatória e pós-operatória de interleucina-6 (IL-6) e interleucina-10 (IL-10) entre pacientes submetidos à colecistectomia laparotômica versus videolaparoscópica. MÉTODOS: De um total de 20 pacientes, 18 foram incluídos no estudo, sendo nove submetidos à colecistectomia laparoscópica e os outros nove utilizando a técnica laparotômica. As concentrações séricas de IL-6 e IL-10 foram dosadas em ambos os grupos. As amostras de sangue foram obtidas nos tempos de 24 horas no pré-operatório, quatro, 12 e 24 horas após o procedimento. Os grupos foram comparados em relação à idade, sexo, índice de massa corpórea (IMC), tempo de anestesia e de operação. RESULTADOS: Não houve diferenças significativamente estatísticas entre os grupos relacionadas à idade, sexo, IMC, tempo de anestesia e de operação. A comparação entre a colecistectomia laparotômica e laparoscópica demonstrou diferenças estatísticas nos níveis de IL-6 no tempo 12 horas após operação (218,64pg/ml laparotômica versus 67,71pg/ml laparoscópica, p=0,0003) e IL-10 no tempo de 24 horas após o procedimento (24,46pg/ml aberta versus 10,17pg/ml laparoscópica, p <0,001). CONCLUSÃO: Houve aumento das dosagens de interleucinas-6 e 10 após o trauma cirúrgico. Ocorreu aumento significativo dos níveis das interleucinas analisadas no grupo laparotômico em comparação com o grupo laparoscópico.

OBJECTIVE: To correlate serum preoperative and postoperative interleukin-6 and interleukin-10 levels in patients undergoing laparotomy versus laparoscopic cholecystectomy. METHODS: From a total of 20 patients, 18 were included in the study, nine underwent cholecystectomy by laparoscopy and the other nine by laparotomy. Serum concentrations of IL-6 and IL-10 were measured in both groups. Blood samples were obtained in the times of 24 hours preoperatively and four, 12 and 24 hours after the procedure. The groups were compared regarding age, gender, body mass index (BMI), duration of anesthesia and operation. RESULTS: There was no significant statistical differences between groups related to age, gender, BMI, duration of anesthesia and operation. The comparison between the two procedurs demonstrated statistical differences for IL-6 in time 12 hours after operation (218.64 pg/ml laparotomic versus 67.71 pg/ml laparoscopic, p = 0.0003) and for IL-10 in time 24 hours after the procedure (24.46 pg/ml open versus 10.17 pg/qml laparoscopic, p <0.001). CONCLUSION: There was an Increase in plasma levels of interleukin-6 and 10 after surgical trauma with a significant increase in levels of interleukins in the laparotomic group in comparison with the laparoscopic group.

OBJETIVO: avaliar a história familial e as características dos tumores em dois grupos distintos por sua faixa etária, bem como questionar quanto à necessidade de colectomia estendida, baseando-se nestas características. MÉTODO: Em estudo retrospectivo analisaram-se 106 pacientes por meio do prontuário e de contato telefônico com o próprio doente e/ou familiares, operados no HC-UFPR. Foram divididos em 2 grupos: Grupo A (n=51) com 55 anos ou menos, e Grupo B (n=55) com mais de 55 anos. Avaliou-se o número de doentes com parentes de 1º. grau com câncer colorretal e em outros sítios; o número de parentes com CCR; o sítio do tumor; o estadiamento TNM; os óbitos no período e a presença de neoplasias associadas. RESULTADOS: No grupo A, 16 (31,4%) pacientes tinham parentes com câncer colorretal. No grupo B, sete (12,7%) (p=0,032). No grupo A houve 16 (31,4%) pacientes de familiares com outro tipo de neoplasia. No grupo B, 19 (34,5%) doentes (p=0,837). Ao incluírem-se apenas as neoplasias associadas à Síndrome do HNPCC, como endométrio e estômago, houve 5 (9,8%) pacientes no grupo A e 3 (5,9%) no grupo B (p=0,477). No grupo A, 3 (5,8%) doentes apresentaram neoplasias associadas ao CCR, sendo elas estômago, rim e bexiga. No grupo B, 3 (5,4%) doentes, mas os tumores eram de mama e próstata (p=0,624). Predominou no grupo A pacientes com estádio III (41,2%) e no grupo B, o estádio II (51,9%) (p=0,480). Houve 19,6% de óbitos no grupo A e 32,7% no Grupo B (p=0,185). CONCLUSÃO: Pacientes com idade = 55 anos possuem história familial mais representativa para o CCR que pacientes mais idosos, podendo fazer parte da síndrome do HNPCC. Possivelmente se beneficiem de colectomia estendida.

AIM: To evaluate the family history and the characteristics of the tumors in two different groups of patients, divided by age, questioning the necessity of extensive colectomy for the adequate treatment. METHODS: One hundred and six patients were analyzed retrospectively by hospital chart review or phone contact either with the patient or a next of keen; all were operated at the University Hospital of the "Universidade Federal do Paraná" (Brazil).These patients were divided in Group A (n=51) below 55 years old, and Group B (n=55) with age above 55 years. All patients were analyzed for first degree relatives with history of colon and rectal cancer and cancer history in other organs; number of relatives with colon and rectal cancer; the location of the tumors in the colon; the TNM staging; the occurrence of other malignant neoplasias for each patient; and the death rate for the period of the study. RESULTS: On group A, 16 (31.4%) patients had relatives with colorectal cancer; on group B, 7 (12.7%) (p=0,032). On group A, 16 (31.4%) patients had relatives with other types of malignant neoplasias, and on group B, 19 (34.5%) (p=0.837). When it was considered only cancers related to the HNPCC syndrome, as endometrium and stomach, 5 (9.8%) patients were found on group A and 3 (5.9%) on group B (p=0.477). On group A, 3 (5.8%) patients had tumors related to colon and rectal cancers, as stomach, kidney and bladder. On group B, 3 (5.4%) patients, but these tumors were in the breast and prostate (p=0.624). On group A, there were more patients with stage III cancers (41.2%) and on group B, stage II cancers were more prevalent (51.9%) (p=0.480). The death rate was 19.6% on group A and 32.7% on group B (p=0.185). CONCLUSION: Patients under 55 years of age have an increased family history of colon and rectal cancer when compared to the ones above the age of 55; those could be related to the HNPCC syndrome. These patients can benefit from an extended colectomy.

OBJETIVO: Estudar comparativamente a cicatrização e a formação de aderências em baço de ratos submetidos à trauma operatório e corrigidos utilizando octil-2-cianoacrilato (DE) e fio de poliglecaprone 25 (CA). MÉTODO: 30 ratos machos Wistar foram separados em três grupos de 10 animais, anestesiados de acordo com as normas do COBEA, submetidos à laparotomia xifopúbica e com uma tesoura Metzenbaum, foi realizada uma lesão esplênica com 4mm de profundidade, na borda anti-hilar do pólo inferior do baço. No Grupo CA, suturou-se a lesão com pontos contínuos de poliglecaprone 25; no Grupo DE, com octil-2-cianoacrilato e no Grupo CO, não houve sutura. Após 14 dias, os ratos foram submetidos à eutanásia e as aderências anotadas em protocolo próprio. O estudo anatomopatológico foi realizado nas colorações hematoxilina-eosina e Picro-Sirius, sendo do tipo fechado, duplo-cego. RESULTADOS: O Grupo DE apresentou menos aderências e menor reação de cicatrização tipo corpo estranho que o CA. Ambos mostram quantidade semelhante de colágeno jovem e maduro. CONCLUSÕES: O octil-2-cianoacrilato provocou menos aderências macroscópicas que o fio de poliglecaprone corado e não induziu cicatrização com reação de corpo estranho, mostrando-se efetivo no reparo das lesões traumáticas esplênicas, em ratos.

BACKGROUND: To study comparatively the healing and the adhesion formation in rats' spleen that were submitted to spleen surgical trauma and sutured with octil-2-cyanoacrylate (DE group) and 25-poliglecaprone thread (CA group). METHODS: Three groups of 10 Wilstar male rats each were used. They were anaesthetized according to the COBEA technique rules and were submitted to xyphoid-pubic laparotomy and the spleen was exposed. A 4mm deep spleen injury at the inferior pole in diaphragmatic face was done with a Metzenbaum scissors. In the CA group the injured was sutured with continuous stitches using 25-poliglecaprone thread; in the DE group octil-2-cyanoacrylate was used; and no suture was done in the CO group (control). After 14 days the rats underwent euthanasia and adhesions were noted in an appropriate protocol. Hematoxilin-eosin and Pycro-sirius stain films were made and readings were done in a double bind way. RESULTS: At DE group less adhesions, less abscess formation and smaller healing reaction of foreign body were seen than the CA group. Both showed equivalent quantity of young (type I) and mature (type III) collagen. CONCLUSION: Octil-2-cyanoacrylate provoked less macroscopic adhesions than 25-poliglecaprone thread and it didn't induce healing reaction of foreign body type, showing effective repair in the traumatic injury of rats' spleen.

OBJETIVOS: Analisar as características demográficas, a mortalidade e morbidade associada ao procedimento. MÉTODOS: Estudo retrospectivo dos casos de reconstrução intestinal colônica um hospital universitário. Todos os pacientes tiveram o cólon preparado por solução de manitol. RESULTADOS: Do total de 42 pacientes, 80,9% (n=34) eram do sexo masculino com idade média de 42 anos. Causas que levaram a confecção da ostomia: 50% traumáticas, 29% abdome agudo clínico. A colostomia terminal foi o tipo de ostomia preferencialmente realizada em 65% dos casos acompanhado pela colostomia em alça com 35% dos casos. A técnica empregada para a anastomose foi predominantemente a manual, realizada em 69,05% dos casos (n=29). O tempo médio de internação hospitalar foi de 8,74 dias. O índice de morbidade global foi de 26,2% (n=11), destacando-se a reoperação em 9,52% (n=4) e a fístula em 7,14% (n=3) dos casos. Não ocorreu infecção de ferida operatória nessa série. A mortalidade foi de 2,38% (n=1). CONCLUSÕES: Os resultados obtidos em um hospital universitário são semelhantes aos relatados na literatura mundial. Cuidados pré e pós operatórios adequados se somam a experiência do cirurgião nas cirurgias de reconstrução de trânsito. A escolha da técnica cirúrgica deve ser padronizada através de trabalho randomizado, permitindo adoção de protocolo.

OBJECTIVES: To study demographyc caractheristics, morbidity and mortality associated to the procedure. METHODS: Retrospective study of colostomy closure in 42 patients. Male sex was predominant (80,9%) with median age of 42 years. Causes of colostomy were traumatic in 50% and clinic acute abdomen in 29% of the cases. Terminal colostomy was the more frequent procedure (65%) followed by loop colostomy in 35% of the cases. The predominant anastomotic technique was manual (69,05%). The morbidity rate was 26,2%, including reoperation (9,52%) and colonic fistulae in 7,14% cases. No postoperative wound infection was observed. Overall mortality rate was 2,38%. CONCLUSION: The results observed in a university hospital are as good as reported in world literature. Adequate pre and postoperative care works together with surgeon experience on colostomy closure surgeries. The surgical technique must be adopted using a randomized study, allowing establishment of a protocol.