ABSTRACT Purpose: To evaluate the impact of simulators on the training of urology residents in retrograde intrarenal surgery (RIRS). Methods: The study involved training eight urology residents, using two artificial simulators; one developed by the Universidade Estadual do Pará, using three-dimensional printing technology, and the other one patented by the medical equipment manufacturer Boston Scientific The qualification of residents took place through a training course, consisting of an adaptation phase (S0), followed by three training sessions, with weekly breaks between them (S1, S2 and S3). Study members should carry out a RIRS in a standardized way, with step-by-step supervision by the evaluator using a checklist. The participants’ individual performance was verified through a theoretical assessment, before and after training (pre- and post-training), as well as by the score achieved in each session on a scale called global psychomotor skill score. In S3, residents performed an analysis of the performance and quality of the simulation, by completing the scale of student satisfaction and self confidence in learning (SSSCL). Results: At the end of the course, everyone was able to perform the procedure in accordance with the standard. The training provided a learning gain and a considerable improvement in skills and competencies in RIRS, with p < 0.05. SSSCL demonstrated positive feedback, with an overall approval rating of 96%. Conclusions: Artificial simulators proved to be excellent auxiliary tools in the training of urology residents in RIRS. Purpose . (RIRS) Methods Pará threedimensional dimensional technology course S0, S0 S , (S0) sessions S1, S1 (S1 S3. S3 S3) way stepbystep step checklist participants assessment pre (pre posttraining, posttraining post post-training) simulation SSSCL. (SSSCL) Results standard 005 0 05 0.05 feedback 96 96% Conclusions (RIRS (S0 (S post-training (SSSCL 00 0.0 9 0.

ABSTRACT Purpose: To analyze the average time between submission and acceptance of national journals in seven Brazilian surgery journals from 2017 to 2022. Methods: It consists of a cross-sectional and observational study with a quantitative approach to analyze the acceptance time of articles approved by Brazilian journals on general surgery and its subspecialties, including Acta Cirúrgica Brasileira, Jornal Vascular Brasileiro, Arquivos Brasileiros de Cirurgia de Digestiva, Revista do Colégio Brasileiro de Cirurgiões, Journal of Coloproctology, Revista Brasileira de Cirurgia Plástica, and International Brazilian Journal of Urology. Results: The journals with the lowest average waiting times were Revista do Colégio Brasileiro de Cirurgiões, Acta Cirúrgica Brasileira, and Journal of Coloproctology, respectively, and, with the lowest interquartile range there is Acta Cirúrgica Brasileira. There was no significant difference between the pre-pandemic and pandemic periods. The study designs with the highest and lowest means were, respectively, ideas and innovations – also with the highest interquartile range – and expert opinion, while with the lowest interquartile range was technical skill. Conclusions: The acceptance time for articles in Brazilian surgery journals is extremely variable. Identifying these discrepancies highlights the importance of understanding editorial processes and seeking ways to improve consistency and efficiency in reviewing articles. Purpose 201 2022 Methods crosssectional cross sectional subspecialties Digestiva Cirurgiões Coloproctology Plástica Urology Results respectively prepandemic pre periods opinion skill Conclusions variable 20 202 2

RESUMO A hipertrofia do clitóris é uma condição que repercute negativamente na vida íntima da mulher e pode causar constrangimento e impacto na vida sexual. O artigo descreve uma técnica cirúrgica de clitoroplastia realizada com incisão subcoronal circunferencial de 360° apenas na pele e na túnica de Dartos para evitar danos neuronais, seguida do desenluvamento até a base do clitóris, preservando o feixe neurovascular dorsal. Prosseguiu-se com a amputação do corpo do clitóris, preservando 0,5 cm do coto da haste clitoriana, e a glande suturada ao restante do tecido esponjoso remanescente. Destaca-se, por fim, que não houve queixas de perda de sensibilidade ou disfunções sexuais no pós-operatório. sexual 360 neuronais dorsal Prosseguiuse Prosseguiu se 05 0 5 0, clitoriana remanescente Destacase, Destacase Destaca se, Destaca-se fim pósoperatório. pósoperatório pós operatório. operatório pós-operatório 36 3

ABSTRACT Clitoral hypertrophy is a condition that has a negative impact on a womans intimate life and can cause embarrassment and impact on her sexual life. The article describes a surgical technique of clitoroplasty performed with a 360° circumferential subcoronal incision only in the skin and Dartos tunica to avoid neuronal damage, followed by degloving to the base of the clitoris, preserving the dorsal neurovascular bundle. The body of the clitoris was amputated, preserving 0.5 cm of the stump of the clitoral shaft, and the glans was sutured to the rest of the remaining spongy tissue. Finally, it is noteworthy that there were no complaints of loss of sensitivity or sexual dysfunctions post-operatively. 360 damage bundle amputated 05 0 5 0. shaft tissue Finally postoperatively. postoperatively post operatively. operatively post-operatively 36 3

ABSTRACT Objective: To describe the distribution profile of thyroidectomies in Brazil from 2010 to 2020 from a macro-regional perspective. Materials and methods: This is a retrospective, detailed and descriptive study built on secondary data obtained from the Hospital Information System of the Unified Health System (SIH/SUS). We organized the data in tables and grouped them according to the federative unit, macro-region, type of procedure, mortality rate, and year of performance. We performed statistical analysis using the χ2 test to assess the association between the variables, observing a P value of < 0.05 and a confidence interval of 95%. Results: From 2010 to 2020, 160 219 thyroidectomy surgeries were performed, of which 77 812 (48.56%) were total, 38 064 (23.76%) partial and 41 191 (25.70%) oncological.The Southeast was responsible for the largest share of procedures, with 70 745 (44.15%), followed by the Northeast with 43 887 (27.39%). In 2020, the procedure was less performed, with 9226 (5.75%) surgeries. The total mortality rate was 0.16% during the study period. Conclusion: We found that thyroidectomies are carried out mainly in the Southeastern, Northeastern, and Southern regions, and showed a downward trend in 2020, which may be related to the COVID-19 pandemic. In addition, total thyroidectomy is the most performed surgery, and the Northern region had the highest mortality rate. Objective 201 202 macroregional macro regional perspective methods retrospective SIH/SUS. SIHSUS SIH/SUS . SIH SUS (SIH/SUS) unit macroregion, macroregion region, macro-region performance χ variables 005 0 05 0.0 95 95% Results 16 21 7 81 48.56% 4856 48 56 (48.56% 3 06 23.76% 2376 23 76 (23.76% 4 19 25.70% 2570 25 (25.70% oncologicalThe oncological procedures 74 44.15%, 4415 44.15% , 44 15 (44.15%) 88 27.39%. 2739 27.39% 27 39 (27.39%) 922 5.75% 575 5 75 (5.75% 016 0.16 period Conclusion Southeastern Northeastern regions COVID19 COVID COVID-1 pandemic addition surgery 20 (SIH/SUS 00 0. 9 1 2 8 48.56 485 (48.56 23.76 237 (23.76 25.70 257 (25.70 441 44.15 (44.15% 273 27.39 (27.39% 92 5.75 57 (5.75 01 0.1 COVID1 COVID- 48.5 (48.5 23.7 (23.7 25.7 (25.7 44.1 (44.15 27.3 (27.39 5.7 (5.7 48. (48. 23. (23. 25. (25. 44. (44.1 27. (27.3 5. (5. (48 (23 (25 (44. (27. (5 (4 (2 (44 (27 (

Resumo Objetivo Avaliar os efeitos do colágeno hidrolisado e do peptídeo de colágeno no tratamento de lesões condrais superficiais de ratos. Método Foram utilizados 18 Rattus norvegicus nesta pesquisa. O dano articular foi induzido por uma única infiltração intra-articular de iodoacetato de sódio (solução 2 mg), injetada através do ligamento patelar da articulação dos animais previamente anestesiados. Os animais foram distribuídos em três grupos: grupo controle, grupo peptídeo de colágeno e grupo colágeno hidrolisado. O tratamento foi realizado por 30 dias com a administração via oral do peptídeo de colágeno ou do colágeno hidrolisado. Posteriormente, foi realizada a eutanásia dos experimentos e seguiu-se para o estudo das alterações condrais articulares. Os resultados foram avaliados conforme contagem de condrócitos por cluster e através da avaliação histológica segundo Pritzker et al. Resultados Ao observar os estágios de lesão, não foi observada significância estatística entre os grupos controle, colágeno hidrolisado e peptídeo de colágeno (p= 0,11). Ao observar os escores, houve significância estatística na comparação do grupo tratado com colágeno hidrolisado e o grupo peptídeo colágeno (p< 0,05), porém sem diferença estatística em relação ao grupo controle. Conclusão Os tratamentos propostos da lesão condral induzida com uso de colágeno hidrolisado ou peptídeos de colágeno via oral mostraram-se eficazes, com estabilização ou regressão da lesão apresentada em ratos, merecendo novas pesquisas experimentais com o intuito de compreender e melhorar o desfecho primário deste trabalho. ratos 1 pesquisa intraarticular intra solução mg, mg , mg) anestesiados controle 3 Posteriormente seguiuse seguiu se articulares al p= p (p 0,11. 011 0,11 . 0 11 0,11) escores p< 0,05, 005 0,05 05 0,05) mostraramse mostraram eficazes trabalho 01 0,1 00 0,0 0,

Abstract Objective To evaluate the effects of hydrolyzed collagen and collagen peptide in the treatment of superficial chondral lesions in rats. Method This research employed 18 Rattus norvegicus. A single intraarticular infiltration of sodium iodoacetate (2 mg solution) through the patellar ligament induced joint damage in previously anesthetized animals. We divided the animals into three groups: a control group, a collagen peptide group, and a hydrolyzed collagen group. Treatment consisted of oral administration of collagen peptide or hydrolyzed collagen for 30 days. Afterwards, we euthanized the animals and studied the joint chondral changes. We evaluated the results according to the chondrocyte clusters count and a histological evaluation, as per Pritzker et al. Results There was no statistical significance in injury stages between the control, hydrolyzed collagen, and collagen peptide groups (p= 0.11). Regarding scores, there was a statistical significance between the groups treated with hydrolyzed collagen and collagen peptide (p< 0.05), but not in comparison with the control group. Conclusion The proposed treatments of the induced chondral lesion with the oral administration of hydrolyzed collagen or collagen peptides were effective, resulting in lesion stabilization or regression, and warranting further experimental research to understand and improve the primary outcome of this study. rats 1 norvegicus 2 ( solution group 3 days Afterwards changes evaluation al p= p (p 0.11. 011 0.11 . 0 11 0.11) scores p< 0.05, 005 0.05 , 05 0.05) effective regression study 01 0.1 00 0.0 0.

ABSTRACT Purpose: To evaluate the gain of microsurgical skills and competencies by urology residents, using low-fidelity experimental models. Methods: The study involved the use of training boards, together with a low-fidelity microsurgery simulator, developed using a 3D printer. The model consists in two silicone tubes, coated with a resin, measuring 10 cm in length and with internal and external diameters of 0.5 and 1.5 mm. The support for the ducts is composed by a small box, developed with polylactic acid. The evaluation of the gain of skills and competencies in microsurgery occurred throughout a training course consisting of five training sessions. The first sessions (S1-S4) took place at weekly intervals and the last session (S5) was performed three months after S4. During sessions, were analyzed: the speed of performing microsurgical sutures in the pre and post-training and the performance of each resident through the Objective Structure Assessment of Technical Skill (OSATS) and Student Satisfaction Self-Confidence tools in Learning (SSSCL). Results: There was a decrease in the time needed to perform the anastomosis (p=0.0019), as well as a progressive increase in the score in the OSATS over during sessions S1 to S4. At S5, there was a slightly decrease in performance (p<0.0001), however, remaining within the expected plateau for the gain of skills and competences. The SSSCL satisfaction scale showed an overall approval rating of 96.9%, with a Cronback alpha coefficient of 83%. Conclusions: The low-fidelity simulation was able to guarantee urology residents a solid gain in skills and competencies in microsurgery. Purpose lowfidelity low fidelity models Methods boards simulator D printer tubes resin 1 05 0 5 0. 15 1. mm box acid S1S4 SS S4 S (S1-S4 S5 (S5 analyzed posttraining post (OSATS SelfConfidence Self Confidence SSSCL. . (SSSCL) Results p=0.0019, p00019 p p=0.0019 , 0019 (p=0.0019) p<0.0001, p00001 p<0.0001 0001 (p<0.0001) however competences 969 96 9 96.9% 83 83% Conclusions S1S (S1-S (S (SSSCL p0001 p=0.001 001 (p=0.0019 p0000 p<0.000 000 (p<0.0001 96.9 8 p000 p=0.00 00 (p=0.001 p<0.00 (p<0.000 96. p00 p=0.0 (p=0.00 p<0.0 (p<0.00 p0 p=0. (p=0.0 p<0. (p<0.0 p=0 (p=0. p<0 (p<0. p= (p=0 p< (p<0 (p= (p< (p

■ RESUMO Introdução: O diagnóstico tardio do câncer de mama eleva o número de cirurgias, resultando em alta mortalidade e resultado pouco estético. Assim, é fundamental a instituição de procedimentos de reconstrução mamária. Método: Estudo descritivo, quantitativo e retrospectivo sobre as autorizações de internação hospitalar de pacientes submetidos a procedimentos cirúrgicos de mama em oncologia, no período de 2011 a 2020, cujo dados foram obtidos na plataforma DATASUS. Resultados: 7.529 cirurgias de câncer de mama e 1.949 cirurgias reparadoras foram realizadas na Região Norte. Houve aumento do número de procedimentos ao longo da década. Em todos os estados é possível perceber a diferença no número de municípios de residência, comparado aos municípios de internação. Conclusão: Necessita-se instituir centros de referência oncológica, garantindo tratamento individualizado e a reconstrução mamária. Introdução estético Assim mamária Método descritivo oncologia 201 2020 DATASUS Resultados 7529 7 529 7.52 1949 1 949 1.94 Norte década residência Conclusão Necessitase Necessita se oncológica 20 202 752 52 7.5 194 94 1.9 2 75 5 7. 19 9 1.

■ ABSTRACT Introduction: Late breast cancer diagnosis increases the number of surgeries, resulting in high mortality and unsightly results. Therefore, the institution of breast reconstruction procedures is essential. Method: Descriptive, quantitative, and retrospective study on authorizations for hospital admission of patients undergoing breast surgical procedures in oncology from 2011 to 2020, whose data were obtained from the DATASUS platform. Results: 7,529 breast cancer surgeries and 1,949 reconstructive surgeries were performed in the North Region. There was an increase in the number of procedures throughout the decade. In all states, it is possible to notice the difference in the number of municipalities of residence compared to the municipalities of hospitalization. Conclusion: It is necessary to establish oncological reference centers, guaranteeing individualized treatment and breast reconstruction. Introduction results Therefore essential Method Descriptive quantitative 201 2020 platform Results 7529 7 529 7,52 1949 1 949 1,94 Region decade states hospitalization Conclusion centers 20 202 752 52 7,5 194 94 1,9 2 75 5 7, 19 9 1,

ABSTRACT Purpose: To evaluate the viability of the porcine vas deferens as a realistic microsurgical training model for vasectomy reversal Methods: The model uses swine testicles (vas deferent), which are usually discarded in large street markets since they are not part of Brazilian cuisine. The spermatic cord was carefully dissected, and the vas deferens were isolated, measuring 10 cm in length. A paper quadrilateral with 5 cm2 was built to delimit the surgical training field. The objective of the model is to simulate only the microsurgical step when the vas deferens are already isolated. The parameters analyzed were: feasibility for reproducing the technique, patency before and after performing the vasovasostomy, cost of the model, ease of acquisition, ease of handling, execution time, and model reproducibility. Results: The simulator presented low cost. All models made were viable with a texture similar to human, with positive patency obtained in 100% of the procedures. The internal and external diameters of the vas deferens varied between 0.2-0.4 mm and 2-3 mm, respectively, with a mean length of 9 ± 1.2 cm. The total procedure time was 43.28 ± 3.22 minutes. Conclusions: The realistic model presented proved to be viable for carrying out vasectomy reversal training, due to its low cost, easy acquisition, and easy handling, and providing similar tissue characteristics to humans. Purpose Methods deferent, deferent , deferent) cuisine dissected isolated 1 field technique vasovasostomy acquisition handling reproducibility Results human 100 procedures 0.20.4 0204 0.2 0.4 0 2 4 0.2-0. 23 3 2- respectively 12 1. 4328 43 28 43.2 322 22 3.2 minutes Conclusions humans 20 0.20. 020 02 0. 04 0.2-0 432 43. 32 3. 0.20 0.2-

ABSTRACT Purpose: To introduce a new low-cost simulation model for training basic surgical skills. Methods: The training model was made from a mixture of 20 g of acetic silicone with 11 g of maize starch. Validation consisted of serial training sessions, evaluating the mean pre- and post-training time and the mean final score according to the global rating scale. Results: A decrease in the time required to perform the sutures was observed, comparing the average post and pre-training time of each training day, with a significant correlation between the order of training and the time for performing the simulation. Conclusions: The presented model proved to be capable of simulating the basic suture training skills. It is easy to make, has low cost, and can be easily reproduced in educational institutions. Purpose lowcost cost skills Methods 2 1 starch sessions pre posttraining scale Results observed pretraining day Conclusions make institutions

RESUMO Introdução: historicamente, as especialidades médicas cirúrgicas são, majoritariamente, masculinas, cenário o qual, nos últimos anos, passa por mudanças. Nesse sentido, apesar da relevância do crescimento da participação feminina na carreira médica, pouco se debate sobre a distribuição entre sexos das principais especialidades médicas cirúrgicas no país. Objetivo: discutir o processo de feminização nas especialidades cirúrgicas no Brasil ao longo dos últimos anos, traçando um perfil de distribuição dessas especialidades. Métodos: Trata-se de um estudo retrospectivo e transversal com dados secundários oriundos dos Censos de Demografia Médica no Brasil dos anos de 2011, 2013, 2015, 2018, 2020 e 2023, incluindo as especialidades cirúrgicas:Urologia, Ortopedia e Traumatologia, Cirurgia Torácica, Neurocirurgia, Cirurgia do Aparelho Digestivo, Cirurgia Cardiovascular, Cirurgia da Mão, Cirurgia Geral, Cirurgia de Cabeça e Pescoço, Cirurgia Vascular, Cirurgia Plástica, Oftalmologia, Coloproctologia, Otorrinolaringologia, Cirurgia Pediátrica e Ginecologia e Obstetrícia. Resultados: O sexo masculino prevalece em números, dentre as especialidades cirúrgicas, porém, com menor taxa de crescimento em comparação ao sexo feminino. Especialidades como a urologia, ortopedia e traumatologia e neurocirurgia são majoritariamente masculinas, enquanto a ginecologia e obstetrícia, feminina. Conclusão: evidencia-se que a participação feminina na área médica cirúrgica aumentou significativamente ao longo dos últimos anos. Introdução historicamente masculinas qual mudanças sentido país Objetivo Métodos Tratase Trata 2011 2013 2015 2018 202 2023 cirúrgicasUrologia, cirúrgicasUrologia Urologia, Urologia cirúrgicas:Urologia Traumatologia Torácica Neurocirurgia Digestivo Cardiovascular Mão Geral Pescoço Vascular Plástica Oftalmologia Coloproctologia Otorrinolaringologia Obstetrícia Resultados números porém feminino urologia obstetrícia Conclusão evidenciase evidencia 201 20 2

ABSTRACT Introduction: historically, surgical medical specialties are mostly male, a scenario which, in recent years, has undergone changes. In this sense, despite the relevance of the growth of female participation in the medical career, little is discussed about the distribution between genders of the main surgical medical specialties in the country. Objective: discuss the process of feminization in surgical specialties in Brazil over the last few years, tracing a distribution profile of these specialties. Methods: this is a retrospective and cross-sectional study with secondary data from the Censuses of Medical Demography in Brazil in the years 2011, 2013, 2015, 2018, 2020 and 2023, including the surgical specialties: Urology, Orthopedics and Traumatology, Thoracic Surgery, Neurosurgery, Digestive System Surgery, Cardiovascular Surgery, Hand Surgery, General Surgery, Head and Neck Surgery, Vascular Surgery, Plastic Surgery, Ophthalmology, Coloproctology, Otorhinolaryngology, Pediatric Surgery, and Gynecology and Obstetrics. Results: males prevails in numbers, among the surgical specialties, however, with a lower growth rate compared to females. Specialties such as urology, orthopedics and traumatology and neurosurgery are mostly male, while gynecology and obstetrics are female. Conclusion: it is evident that female participation in the surgical medical field has increased significantly over the last few years. Introduction historically male which changes sense career country Objective Methods crosssectional cross sectional 2011 2013 2015 2018 202 2023 Urology Traumatology Surgery Neurosurgery Ophthalmology Coloproctology Otorhinolaryngology Obstetrics Results numbers however females urology Conclusion 201 20 2

RESUMO Objetivo Descrever e validar um modelo oftalmológico para treinamento de transplante e microssutura de córnea utilizando globo ocular bovino. Métodos Para a montagem do modelo de treinamento, o globo ocular foi disposto sob o campo cirúrgico, apoiado sobre um recipiente plástico cilíndrico comum de 3,5cm de diâmetro, para a retirada da córnea. Foi realizada uma incisão circular superficial, e, posteriormente, uma tesoura Castroviejo curva de 9 cm foi utilizada para remoção completa da córnea, que foi recolocada em sua posição original, para que, em seguida, fossem confeccionados nove pontos equidistantes, usando fio de nylon 10-0. Por fim, foram avaliados os seguintes critérios: tempo de realização das suturas; evolução do tempo e da qualidade a cada teste; e destreza e aperfeiçoamento da realização das suturas. Resultados O modelo descrito demonstrou-se viável e adequado para o treinamento de microssuturas na córnea, possibilitando aperfeiçoamento e ganho de habilidades cirúrgicas. Conclusão O modelo de treinamento microcirúrgico apresentado possui alta viabilidade para a simulação de cirurgias oftalmológicas e textura semelhante à do olho humano real, o que o torna próximo à realidade. bovino cirúrgico 35cm 3 5cm diâmetro superficial posteriormente original seguida equidistantes 100. 100 10 0. 0 10-0 fim critérios suturas teste demonstrouse demonstrou se cirúrgicas real realidade 1 10-

ABSTRACT Objective To describe and validate an ophthalmic model for corneal transplantation and micro suture training using a bovine eyeball as a model. Methods For the training model, the eyeball was placed under the sanitary field placed on the ends of a common 3.5cm diameter cylindrical plastic container for corneal removal. A superficial circular incision was made, then 9cm curved Castroviejo scissors were used for complete corneal removal. The cornea was replaced in its original position, and 10-0 nylon thread was used to perform the sutures, with 9 equidistant stitches. Finally, the following criteria were evaluated: suturing time, time and quality progression in each attempt, dexterity and suturing improvement. Results The described model proved to be feasible and suitable for corneal micro suture training, allowing improvement and gain of dexterity in the sport. Conclusion The presented microsurgical training model has a high feasibility for the simulation of ophthalmic surgeries, in addition to a texture similar to the real human eye, which makes it close to reality. 35cm cm 3 5cm removal made position 100 10 0 10- sutures stitches Finally evaluated attempt sport surgeries eye reality 1

Resumo Contexto As varizes são um agravo que vêm aumentando nos últimos anos e, nos casos mais graves, necessitam de tratamento cirúrgico para a resolução do quadro clínico do paciente. Apesar da sua importância, não há trabalhos epidemiológicos que englobem todo o território brasileiro de modo a demonstrar como está a distribuição das cirurgias para a correção desse agravo pelo Sistema Único de Saúde. Objetivos Descrever o perfil ecológico do tratamento cirúrgico para a correção de varizes no Brasil no período de 2010 a 2020. Métodos O estudo caracteriza-se como descritivo-analítico, mediante a coleta de dados proveniente do Sistema de Informações Hospitalares do Sistema Único de Saúde. Os dados, disponibilizados pela própria plataforma, foram tabelados e categorizados de acordo com o estado, a região, o caráter do procedimento e o ano de realização. O programa BioEstat 5.3 foi utilizado para a realização do teste estatístico de qui-quadrado, sendo adotado o intervalo de confiança de 95% e o valor significativo de p <0,05. Resultados No período de 2010 a 2020, foram realizadas 755.752 cirurgias para o tratamento de varizes, sendo 292.538 unilaterais (38,71%) e 463.214 (61,29%) bilaterais. A região Sudeste foi responsável por 418.791 (55,41%) procedimentos, seguida pelo Sul, com 180.689 (23,91%). Foram registradas 40 mortes pelo procedimento no período analisado, das quais 26 ocorreram em cirurgias bilaterais (65%) e a maioria no Sudeste (24 óbitos). Conclusões Verificou-se que esse procedimento é realizado majoritariamente nas regiões Sudeste e Sul, com maior prevalência da cirurgia bilateral de caráter eletivo.

Abstract Background Varicose veins have become more common over recent years and in the most serious cases surgical treatment is necessary to resolve patients’ clinical status. Despite their importance, there are no epidemiological studies that cover the whole of Brazil, showing how surgery to correct varicose veins conducted by the Unified Health System (SUS) is distributed in the country. Objectives To describe the ecological profile of surgical treatment to correct varicose veins in Brazil from 2010 to 2020. Methods This is a descriptive-analytical study of data obtained from the SUS Hospital Information System. These data were tabulated and categorized by state, region, type of procedure, and year. BioEstat 5.3 was used to conduct chi-square statistical tests with a 95% confidence interval and significance cutoff of p <0.05. Results From 2010 to 2020, 755,752 surgical operations to treat varicose veins were conducted; 292,538 were unilateral (38.71%) and 463,214 (61.29%) were bilateral. Of these, 418,791 (55.41%) procedures were performed in the Southeast region, followed by 180,689 (23.91%) in the South region. A total of 40 deaths were registered in connection with these procedures during the period, 26 of which (65%) were associated with bilateral surgery and the majority of which occurred in the Southeast (24 deaths). Conclusions It was observed that the majority of procedures are performed in the Southeast and South regions, and that bilateral elective surgery is the most prevalent.

ABSTRACT Purpose: To describe the microsurgical anatomical aspects of the extratemporal facial nerve of Wistar rats under a high-definition video system. Methods: Ten male Wistar rats (12–15 weeks old), without veterinary diseases, weighing 220–280 g, were used in this study. All animals in this study were submitted to the same protocol and by the same surgeon. A 10-mm incision was made below the bony prominence of the right or left ear, and extended towards the angle of the mandible. The dissection was performed and the main branches of the facial nerve were dissected. Results: The main trunk of the facial nerve has a length of 0.88 ± 0.10 mm and a length of 3.81 ± 1.03 mm, measured from its emergence from the stylomastoid foramen to its bifurcation. Seven branches originating from the facial nerve were identified: posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic. Conclusions: The anatomy of the facial nerve is comparable to that of humans, with some variations. The most observed anatomical division was the distribution in posterior auricular, posterior cervical, cervical, mandibular, buccal, temporal, and zygomatic branches. There is no statistical difference between the thickness and distance of the structures compared to the contralateral side.

Resumo Contexto A produção científica brasileira cresce de forma quantitativa e qualitativa a cada década. Entretanto, há uma desvalorização dos periódicos brasileiros demonstrada através da baixa quantidade de citações em comparação a textos de revistas internacionais, com justificativa subentendida de que há superioridade qualitativa de artigos estrangeiros. Objetivos Verificar a diferença entre o número de citações de periódicos nacionais e internacionais em três revistas brasileiras no período de 2016 a 2020. Métodos Foram analisados todos os artigos publicados na Revista do Colégio Brasileiro de Cirurgiões, no Jornal Vascular Brasileiro e na Acta Cirúrgica Brasileira no intervalo de 2016 a 2020. Os estudos selecionados tiveram suas referências avaliadas, sendo contabilizado o número total de citações e se eram provenientes de periódicos brasileiros ou de periódicos estrangeiros. Resultados Foram analisados 902 artigos, totalizando 23.394 referências, com média de 25,81 ± 8,59 por artigo. Nesse contexto, 2.680 (11,45%) eram nacionais, correspondentes a uma média de 2,95 ± 3,79 referências brasileiras por artigo. Conclusões Faz-se necessária a maior valorização dos periódicos brasileiros, em especial por parte dos pesquisadores nacionais e das instituições responsáveis pelo fomento da ciência.

Abstract Background The quantity and quality of Brazilian scientific output increases decade by decade. However, there is a tendency to undervalue Brazilian journals, illustrated by the low number of citations compared with texts in international journals, with the tacit justification that foreign articles are of superior quality. Objectives To investigate the differences in numbers of citations of Brazilian and international periodicals in three Brazilian journals from 2016 to 2020. Methods All articles published in the Journal of the Brazilian College of Surgeons, in the Jornal Vascular Brasileiro, and in Acta Cirúrgica Brasileira from 2016 to 2020 were analyzed. The references of these studies were analyzed, summing the total number of citations and classifying them as published in Brazilian or foreign journals. Results A total of 902 articles were analyzed, totaling 23,394 references, with a mean of 25.81 ± 8.59 references per article. Of these, 2,680 (11.45%) were Brazilian, equating to a mean of 2.95 ± 3.79 Brazilian references per article. Conclusions It is necessary to improve appreciation of Brazilian periodicals, especially among Brazilian researchers and institutions responsible for science funding.

ABSTRACT Purpose: To describe the anatomical aspects of the cervical rootlets and to quantify the number of rootlets that compose C1 to T1. Methods: Twenty male rats were used in this study. The dorsal rootlets from C1 to T1 were analyzed. To study the ventral rootlets, the posterior root avulsion was performed using a microhook, allowing exposure of the ventral roots through manipulation of the denticulate ligament and arachnoid mater. The parameters analyzed were the number of ventral and dorsal rootlets by side and level. Results: The formation of the respective spinal nerve was observed in the spinal roots the union of the ventral and dorsal roots. In four animals the C1 spinal root had no dorsal and/or ventral contribution. There is no normal pattern of numerical normality of the dorsal and ventral rootlets. The average number of fascicles per root was 4.08, with a slight superiority on the left side. There was a slight superiority of the dorsal rootlets compared to the ventral rootlets. Conclusions: This investigation was the first to study cervical rootlets in rats. In 20% of the sample studied, the dorsal root of C1 was absent mainly on the left side. There is a nonlinear numerical increase from C1 to T1 in the rootlets. There is a numerical predominance of cervical fascicles on the left side, confronting several studies related to the functional predominance of right laterality, requiring new studies that correlate these variables.