Apical access and closure devices for transapical transcatheter heart valve procedures.

The majority of transcatheter aortic valve implantations, structural heart procedures and the newly developed transcatheter mitral valve repair and replacement are traditionally performed either through a transfemoral or a transapical access site, depending on the presence of severe peripheral vascular disease or anatomic limitations. The transapical approach, which carries specific advantages related to its antegrade nature and the short distance between the introduction site and the cardiac target, is traditionally performed through a left anterolateral mini-thoracotomy and requires rib retractors, soft tissue retractors and reinforced apical sutures to secure, at first, the left ventricular apex for the introduction of the stent-valve delivery systems and then to seal the access site at the end of the procedure. However, despite the advent of low-profile apical sheaths and newly designed delivery systems, the apical approach represents a challenge for the surgeon, as it has the risk of apical tear, life-threatening apical bleeding, myocardial damage, coronary damage and infections. Last but not least, the use of large-calibre stent-valve delivery systems and devices through standard mini-thoracotomies compromises any attempt to perform transapical transcatheter structural heart procedures entirely percutaneously, as happens with the transfemoral access site, or via a thoracoscopic or a miniaturised video-assisted percutaneous technique. During the past few years, prototypes of apical access and closure devices for transapical heart valve procedures have been developed and tested to make this standardised successful procedure easier. Some of them represent an important step towards the development of truly percutaneous transcatheter transapical heart valve procedures in the clinical setting.

Suturas mecânicas

The authors review the use of staplers in General Surgery, mainly in Gastroenterological Surgery highlighting safety and effectiveness. They emphasize that the mechanic anastomosis are a viable technique and in some conditions, the best way to perform the anastomosis. The use of staplers makes surgery faster and easier and complications are, generally related to surgeon's experience in using them. Although its costs are higher compared to handsewn suture, it can make the patient total cost lower.

Modified method for bronchial suture by Ramirez Gama compared to separate stitches suture: experimental study

OBJECTIVE: To experimentally compare two classic techniques described for manual suture of the bronchial stump.METHODS: We used organs of pigs, with isolated trachea and lungs, preserved by refrigeration. We dissected 30 bronchi, which were divided into three groups of ten bronchi each, of 3mm, 5mm, and 7mm, respectively. In each, we performed the suture with simple, separated, extramucosal stitches in five other bronchi, and the technique proposed by Ramirez and modified by Santos et al in the other five. Once the sutures were finished, the anastomoses were tested using compressed air ventilation, applying an endotracheal pressure of 20mmHg.RESULTS: the Ramirez Gama suture was more effective in the bronchi of 3, 5 and 7 mm, and there was no air leak even after subjecting them to a tracheal pressure of 20mmHg. The simple interrupted sutures were less effective, with extravasation in six of the 15 tested bronchi, especially in the angles of the sutures. These figures were not significant (p = 0.08).CONCLUSION: manual sutures of the bronchial stumps were more effective when the modified Ramirez Gama suture was used in the caliber bronchi arms when tested with increased endotracheal pressure.

Long-term professional performance of minimally invasive surgery post-graduates

OBJECTIVE: to evaluate the contribution of a post-graduation program in surgeons professional careers. METHODS: participants were asked to answer a questionnaire with questions related to possible changes in their professional performance after the end of the course. RESULTS: forty-three (76.7%) of the 56 participants eligible for the study responded to the questionnaires. Most participants, 32 (74.4%), had previous contact with laparoscopic surgery; however, only 14 (32.5%) reported the experience as primary surgeon. The expectations on the course were reached or exceeded for 36 (83.7%) participants. Thirty-seven (86%) incorporated minimally invasive procedures in their daily surgical practice, 37 (86%) reported improvements in their income above 10% and 12% reported income increase of over 100%, directly related to their increase of laparoscopic activity. CONCLUSION: the program in minimally invasive surgery provides a high level of satisfaction to its participants, enables them to perform more complex technical procedures, such as sutures, and improves their professional economic performance.

Urethroplasty using a bovine pericardium graft: an experimental study using normal urethras from dogs

The use of bovine pericardium as a urethral patch to substitute a ventral segment of canine urethras was studied. Healing, epithelial growth, urethral permeability, fistulas, and calcification were analyzed. Thirty male mongrel dogs of medium and large size underwent resection of a ventral segment of the medial urethra measuring 2.0 x 0.5 cm, which was replaced with a bovine pericardium graft, treated with buffered glutaraldehyde and preserved in formaldehyde. Two running sutures of polygalactin 5-0 were applied, one on each side of the patch. The corpus spongiosum was closed with uninterrupted suture and the skin with interrupted suture of polygalactin 5-0. Six months later, the animals were examined and sacrificed under anesthesia. Retrograde urethrograms showed that the urethral healing was complete in six of the 30 animals, without stenosis, fistulas or dilations. Microscopic examination showed complete epithelization of these six urethras. The remaining 24 animals presented urethrocutaneous fistulas without stenosis, demonstrated by urethral catheterism using a 10-Fr plastic catheter. These data show that a successful urethral reconstruction of the penile urethra was possible in only 20% of the operated animals. Infection and leakage may be the cause of the urethrocutaneous fistulas present in 80% of cases. Further studies are necessary to determine whether such fistulas are avoidable. If they are, the bovine pericardium may well be an option in the treatment of urethral lesions in dogs.

Effect of neurotrophic factor, MDP, on rats’ nerve regeneration

Our objective was to determine the immune-modulating effects of the neurotrophic factor N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP) on median nerve regeneration in rats. We used male Wistar rats (120-140 days of age, weighing 250-332 g) and compared the results of three different techniques of nerve repair: 1) epineural neurorrhaphy using sutures alone (group S - 10 rats), 2) epineural neurorrhaphy using sutures plus fibrin tissue adhesive (FTA; group SF - 20 rats), and 3) sutures plus FTA, with MDP added to the FTA (group SFM - 20 rats). Functional assessments using the grasp test were performed weekly for 12 weeks to identify recovery of flexor muscle function in the fingers secondary to median nerve regeneration. Histological analysis was also utilized. The total number and diameter of myelinated fibers were determined in each proximal and distal nerve segment. Two indices, reported as percentage, were calculated from these parameters, namely, the regeneration index and the diameter change index. By the 8th week, superiority of group SFM over group S became apparent in the grasping test (P = 0.005). By the 12th week, rats that had received MDP were superior in the grasping test compared to both group S (P < 0.001) and group SF (P = 0.001). Moreover, group SF was better in the grasping test than group S (P = 0.014). However, no significant differences between groups were identified by histological analysis. In the present study, rats that had received MDP obtained better function, in the absence of any significant histological differences.

Étude comparative de l'anatomie des plaies de greffe de cornée par tomographie de cohérence optique (OCT)

Cette thèse porte sur l’étude de l’anatomie de la cornée après 3 techniques de greffe soient, la greffe totale traditionnelle (GTT) et des techniques de greffe lamellaire postérieur (GLP) telles que la greffe lamellaire endothéliale profonde (DLEK) et la greffe endothélium/membrane de Descemet (EDMG) pour le traitement des maladies de l’endothélium, telles que la dystrophie de Fuchs et de la kératopathie de l’aphaque et du pseudophaque. Dans ce contexte, cette thèse contribue également à démontrer l’utilité de la tomographie de cohérence optique (OCT) pour l’étude de l’anatomie des plaies chirurgicales la cornée post transplantation. Au cours de ce travail nous avons étudié l'anatomie de la DLEK, avant et 1, 6, 12 et 24 mois après la chirurgie. Nous avons utilisé le Stratus OCT (Version 3, Carl Zeiss, Meditec Inc.) pour documenter l’anatomie de la plaie. L'acquisition et la manipulation des images du Stratus OCT, instrument qui à été conçu originalement pour l’étude de la rétine et du nerf optique, ont été adaptées pour l'analyse du segment antérieur de l’oeil. Des images cornéennes centrales verticales et horizontales, ainsi que 4 mesures radiaires perpendiculaires à la plaie à 12, 3, 6 et 9 heures ont été obtenues. Les paramètres suivants ont été étudiés: (1) Les espaces (gap) entre les rebords du disque donneur et ceux du receveur, (2) les dénivelés de surface postérieure (step) entre le les rebords du disque donneur et ceux du receveur, (3) la compression tissulaire, (4) le décollement du greffon, 6) les élévations de la surface antérieure de la cornée et 7) la pachymétrie centrale de la cornée. Les mesures d’épaisseur totale de la cornée ont été comparées et corrélées avec celles obtenues avec un pachymètre à ultra-sons. Des mesures d’acuité visuelle, de réfraction manifeste et de topographie ont aussi été acquises afin d’évaluer les résultats fonctionnels. Enfin, nous avons comparé les données de DLEK à celles obtenues de l’EDMG et de la GTT, afin de caractériser les plaies et de cerner les avantages et inconvénients relatifs à chaque technique chirurgicale. Nos résultats anatomiques ont montré des différences importantes entre les trois techniques chirurgicales. Certains des paramètres étudiés, comme le sep et le gap, ont été plus prononcés dans la GTT que dans la DLEK et complètement absents dans l’EDMG. D’autres, comme la compression tissulaire et le décollement du greffon n’ont été observés que dans la DLEK. Ceci laisse entrevoir que la distorsion de la plaie varie proportionnellement à la profondeur de la découpe stromale du receveur, à partir de la face postérieure de la cornée. Moins la découpe s’avance vers la face antérieure (comme dans l’EDMG), moins elle affecte l’intégrité anatomique de la cornée, le pire cas étant la découpe totale comme dans la GTT. Cependant, tous les paramètres d’apposition postérieure sous-optimale et d’élévation de la surface antérieure (ce dernier observé uniquement dans la GTT) finissent par diminuer avec le temps, évoluant à des degrés variables vers un profil topographique plus semblable à celui d’une cornée normale. Ce processus paraît plus long et plus incomplet dans les cas de GTT à cause du type de plaie, de la présence de sutures et de la durée de la cicatrisation. Les valeurs moyennes d’épaisseur centrale se sont normalisées après la chirurgie. De plus, ces valeurs moyennes obtenues par OCT étaient fortement corrélées à celles obtenues par la pachymétrie à ultra-sons et nous n’avons remarqué aucune différence significative entre les valeurs moyennes des deux techniques de mesure. L’OCT s’est avéré un outil utile pour l’étude de l’anatomie microscopique des plaies chirurgicales. Les résultats d’acuité visuelle, de réfraction et de topographie des techniques de GLP ont montré qu’il existe une récupération visuelle rapide et sans changements significatifs de l’astigmatisme, contrairement à la GTT avec et sans suture. La GLP a permis une meilleure conservation de la morphologie de la cornée, et par conséquence des meilleurs résultats fonctionnels que la greffe de pleine épaisseur. Ceci nous permet d’avancer que la GLP pourrait être la technique chirurgicale à adopter comme traitement pour les maladies de l’endothélium cornéen.

Mechanism and Prediction of Post-Operative Atrial Fibrillation Based on Atrial Electrograms

La fibrillation auriculaire (FA) est une arythmie touchant les oreillettes. En FA, la contraction auriculaire est rapide et irrégulière. Le remplissage des ventricules devient incomplet, ce qui réduit le débit cardiaque. La FA peut entraîner des palpitations, des évanouissements, des douleurs thoraciques ou l’insuffisance cardiaque. Elle augmente aussi le risque d'accident vasculaire. Le pontage coronarien est une intervention chirurgicale réalisée pour restaurer le flux sanguin dans les cas de maladie coronarienne sévère. 10% à 65% des patients qui n'ont jamais subi de FA, en sont victime le plus souvent lors du deuxième ou troisième jour postopératoire. La FA est particulièrement fréquente après une chirurgie de la valve mitrale, survenant alors dans environ 64% des patients. L'apparition de la FA postopératoire est associée à une augmentation de la morbidité, de la durée et des coûts d'hospitalisation. Les mécanismes responsables de la FA postopératoire ne sont pas bien compris. L'identification des patients à haut risque de FA après un pontage coronarien serait utile pour sa prévention. Le présent projet est basé sur l'analyse d’électrogrammes cardiaques enregistrées chez les patients après pontage un aorte-coronaire. Le premier objectif de la recherche est d'étudier si les enregistrements affichent des changements typiques avant l'apparition de la FA. Le deuxième objectif est d'identifier des facteurs prédictifs permettant d’identifier les patients qui vont développer une FA. Les enregistrements ont été réalisés par l'équipe du Dr Pierre Pagé sur 137 patients traités par pontage coronarien. Trois électrodes unipolaires ont été suturées sur l'épicarde des oreillettes pour enregistrer en continu pendant les 4 premiers jours postopératoires. La première tâche était de développer un algorithme pour détecter et distinguer les activations auriculaires et ventriculaires sur chaque canal, et pour combiner les activations des trois canaux appartenant à un même événement cardiaque. L'algorithme a été développé et optimisé sur un premier ensemble de marqueurs, et sa performance évaluée sur un second ensemble. Un logiciel de validation a été développé pour préparer ces deux ensembles et pour corriger les détections sur tous les enregistrements qui ont été utilisés plus tard dans les analyses. Il a été complété par des outils pour former, étiqueter et valider les battements sinusaux normaux, les activations auriculaires et ventriculaires prématurées (PAA, PVA), ainsi que les épisodes d'arythmie. Les données cliniques préopératoires ont ensuite été analysées pour établir le risque préopératoire de FA. L’âge, le niveau de créatinine sérique et un diagnostic d'infarctus du myocarde se sont révélés être les plus importants facteurs de prédiction. Bien que le niveau du risque préopératoire puisse dans une certaine mesure prédire qui développera la FA, il n'était pas corrélé avec le temps de l'apparition de la FA postopératoire. Pour l'ensemble des patients ayant eu au moins un épisode de FA d’une durée de 10 minutes ou plus, les deux heures précédant la première FA prolongée ont été analysées. Cette première FA prolongée était toujours déclenchée par un PAA dont l’origine était le plus souvent sur l'oreillette gauche. Cependant, au cours des deux heures pré-FA, la distribution des PAA et de la fraction de ceux-ci provenant de l'oreillette gauche était large et inhomogène parmi les patients. Le nombre de PAA, la durée des arythmies transitoires, le rythme cardiaque sinusal, la portion basse fréquence de la variabilité du rythme cardiaque (LF portion) montraient des changements significatifs dans la dernière heure avant le début de la FA. La dernière étape consistait à comparer les patients avec et sans FA prolongée pour trouver des facteurs permettant de discriminer les deux groupes. Cinq types de modèles de régression logistique ont été comparés. Ils avaient une sensibilité, une spécificité et une courbe opérateur-receveur similaires, et tous avaient un niveau de prédiction des patients sans FA très faible. Une méthode de moyenne glissante a été proposée pour améliorer la discrimination, surtout pour les patients sans FA. Deux modèles ont été retenus, sélectionnés sur les critères de robustesse, de précision, et d’applicabilité. Autour 70% patients sans FA et 75% de patients avec FA ont été correctement identifiés dans la dernière heure avant la FA. Le taux de PAA, la fraction des PAA initiés dans l'oreillette gauche, le pNN50, le temps de conduction auriculo-ventriculaire, et la corrélation entre ce dernier et le rythme cardiaque étaient les variables de prédiction communes à ces deux modèles.

Haptics in medicine and clinical skill acquisition

THE clinical skills of medical professionals rely strongly on the sense of touch, combined with anatomical and diagnostic knowledge. Haptic exploratory procedures allow the expert to detect anomalies via gross and fine palpation, squeezing, and contour following. Haptic feedback is also key to medical interventions, for example when an anaesthetist inserts an epidural needle, a surgeon makes an incision, a dental surgeon drills into a carious lesion, or a veterinarian sutures a wound. Yet, current trends in medical technology and training methods involve less haptic feedback to clinicians and trainees. For example, minimally invasive surgery removes the direct contact between the patient and clinician that gives rise to natural haptic feedback, and furthermore introduces scaling and rotational transforms that confuse the relationship between movements of the hand and the surgical site. Similarly, it is thought that computer-based medical simulation and training systems require high-resolution and realistic haptic feedback to the trainee for significant training transfer to occur. The science and technology of haptics thus has great potential to affect the performance of medical procedures and learning of clinical skills. This special section is about understanding

Craniosynostosis in Pycnodysostosis: Broadening the Spectrum of the Cranial Flat Bone Abnormalities

Pycnodysostosis is a rare autosomal recessive skeletal dysplasia caused by the absence of active cathepsin K, which is a lysosomal cysteine protease that plays a role in degrading the organic matrix of bones, acting in bone resorption and bone remodeling. The disease is primarily characterized by osteosclerosis, bone fragility, short stature, acro-osteolysis, and delayed closure of the cranial sutures. A differing feature, cranial synostosis, has occasionally been described in this disorder. We reviewed six unrelated patients with pycnodysostosis (mean age of 10 years and 4 months) in order to evaluate the presence of craniosynostosis. In addition to the typical findings of the condition, they all presented premature fusion of the corona! suture. Although none of them showed signs of cranial hypertension, one patient had had the craniosynostosis surgically corrected previously. These data suggest that the cranial sutures in pycnodysostosis can display contradictory features: wide cranial sutures, which are commonly described, and craniosynostosis. The clinical impact of this latter finding still remains to be elucidated. Further studies are necessary to address more precisely the role of cathepsin K in suture patency. (C) 2010 Wiley-Liss, Inc.

Neoproterozoic geodynamic evolution of SW-Gondwana: a southern African perspective

Our current understanding of the tectonic history of the principal Pan-African orogenic belts in southwestern Africa, reaching from the West Congo Belt in the north to the Lufilian/Zambezi, Kaoko, Damara, Gariep and finally the Saldania Belt in the south, is briefly summarized. On that basis, possible links with tectono-stratigraphic units and major structures on the eastern side of the Rio de la Plata Craton are suggested, and a revised geodynamic model for the amalgamation of SW-Gondwana is proposed. The Rio de la Plata and Kalahari Cratons are considered to have become juxtaposed already by the end of the Mesoproterozoic. Early Neoproterozoic rifting led to the fragmentation of the northwestern (in today`s coordinates) Kalahari Craton and the splitting off of several small cratonic blocks. The largest of these ex-Kalahari cratonic fragments is probably the Angola Block. Smaller fragments include the Luis Alves and Curitiba microplates in eastern Brazil, several basement inliers within the Damara Belt, and an elongate fragment off the western margin, named Arachania. The main suture between the Kalahari and the Congo-So Francisco Cratons is suspected to be hidden beneath younger cover between the West Congo Belt and the Lufilian/Zambezi Belts and probably continues westwards via the Cabo Frio Terrane into the Goias magmatic arc along the Brasilia Belt. Many of the rift grabens that separated the various former Kalahari cratonic fragments did not evolve into oceanic basins, such as the Northern Nosib Rift in the Damara Belt and the Gariep rift basin. Following latest Cryogenian/early Ediacaran closure of the Brazilides Ocean between the Rio de la Plata Craton and the westernmost fragment of the Kalahari Craton, the latter, Arachania, became the locus of a more than 1,000-km-long continental magmatic arc, the Cuchilla Dionisio-Pelotas Arc. A correspondingly long back-arc basin (Marmora Basin) on the eastern flank of that arc is recognized, remnants of which are found in the Marmora Terrane-the largest accumulation of oceanic crustal material known from any of the Pan-African orogenic belts in the region. Corresponding foredeep deposits that emerged from the late Ediacaran closure of this back-arc basin are well preserved in the southern areas, i.e. the Punta del Este Terrane, the Marmora Terrane and the Tygerberg Terrane. Further to the north, present erosion levels correspond with much deeper crustal sections and comparable deposits are not preserved anymore. Closure of the Brazilides Ocean, and in consequence of the Marmora back-arc basin, resulted from a change in the Rio de la Plata plate motion when the Iapetus Ocean opened between the latter and Laurentia towards the end of the Ediacaran. Later break-up of Gondwana and opening of the modern South Atlantic would have followed largely along the axis of the Marmora back-arc basin and not along major continental sutures.

Uso da cola de fibrina na anastomose nervosa : estudo comparativo experimental, em ratos

A procura de um método que permita um melhor resultado na anastomose de um nervo completamente seccionado é antiga. Há muitos anos a técnica, dita convencional, para aproximação dos cotos afastados do nervo lesado, é realizada com pontos de fios microcirúrgicos. Mais recentemente, a utilização da cola de fibrina tem permitido a adesão de tecidos, como pele, fáscia e outras estruturas anatômicas. O uso da cola de fibrina, na aproximação das extremidades nervosas, tem sido propagada pela indústria como um fato incontestável. No entanto, somente com a realização de estudos comparativos clínicos e laboratoriais tornou-se possível comparar a eficácia da cola de fibrina como agente de reconstituição em lesões de nervos periféricos. Com o objetivo de comprovar essa afirmação foi realizado um trabalho através de uma mensuração nas bainhas de mielina de cotos regenerados de nervos entre diferentes tipos de anastomose nervosas em nervo isquiático de ratos da raça Wistar. Com esse mesmo escopo, foi mensurado o número de axônios em regeneração após o uso dessa cola. Foi utilizada uma amostra de 35 ratos divididos em 03 grupos (A, B e C). No grupo A, 25 ratos foram submetidos à cirurgia com o uso da cola de fibrina para a anastomose nervosa. No grupo B, 05 ratos foram submetidos ao mesmo procedimento; entretanto, ao reparo nervoso acrescentou-se a utilização de dois pontos opostos de mononylon 9-0, usando-se cola de fibrina no seu interior. No terceiro grupo (C), 05 ratos foram submetidos a neurorrafia com 6 a 8 pontos de mononylon 9-0 sem auxílio da cola de fibrina (anastomose nervosa convencional). Os animais foram submetidos a um novo procedimento após 90 dias, quando o nervo isquiático tratado foi retirado e encaminhado para o estudo. Após esse procedimento, os animais foram sacrificados. Cabe esclarecer que os espécimens foram submetidas a uma preparação histológica, sendo avaliados. Para tanto, foi realizada uma mensuração da espessura média da bainha de mielina das fibras regeneradas. Também foi realizada uma medição do número de axônios regenerados em um milímetro quadrado. Com base nesses achados, foram comparados os resultados.

Comparative study between the effects of hyaluronic acid and acid galactan purified from eggs of the mollusk Pomacea sp in wound healing

To compare the effect of hyaluronic acid (HA) and of AG on the healing of intestine wounds. Methods: The semi-purified extract of the eggs of the mollusc was obtained by fractionation with ammonium sulfate and purification for ion-exchange chromatography. The obtained galactans were eluted in water (neutral galactan) and in 0.1 and 0.2M NaCl (acidic galactans). The in vivo study was performed with 45 “Wistar” rats, separated in three groups (n=15). Solutions containing HA 1%, GA 1% or saline solution 0,9%, was placed topically on the sutures of wounds in the small intestine of the rats. After 05, 10 and 21 days the animals were sacrificed and biopsy of the healing tissue was done. Results: The hystologic grading was more significant for HA and AG groups when compared to the group C. AG stimulated the appearance of macrophages, giant cells and increase in the concentration of collagen in the area of the wound when compared to HA. Conclusion: The topical use of GA in intestinal wounds promoted the anticipation of events that are important in the wound healing

Comparação entre duas técnicas de neurorrafia do digital palmar em eqüinos

Foram comparadas duas técnicas de neurorrafia em seis eqüinos, divididos em três grupos (G), conforme o tempo para a biópsia. Os animais foram submetidos a neurectomia dos nervos digitais palmares (NDP) e aplicaram-se duas suturas epineurais (SE) e suturas com tubos de silicone (STS) em cada animal. Avaliaram-se os animais mensalmente pelo teste de sensibilidade e exame do aparelho locomotor até a realização das biópsias dos NDP. Aos 30 dias pós-cirurgia foi realizada biópsia no GI, aos 60 dias no GII e aos 180 dias no GIII. Macroscopicamente, o NDP encontrou-se envolvido por tecido conjuntivo fibroso. Microscopicamente, constataram-se proliferação axonal em uma amostra do GI e neuromas nas amostras dos GI, GII e GIII. Houve proliferação de tecido conjuntivo em todos os grupos no local de reparação para SE e adentrando no interior do tubo na STS. Visibilizaram-se infiltrado de células inflamatórias, alterações no coto proximal e degeneração no coto distal na SE e na STS. As técnicas não apresentaram resultados satisfatórios quanto ao grau de regeneração do coto proximal até o coto distal.

Aspectos morfométricos da cicatrização do cólon descendente de eqüinos submetidos a enterorrafias aposicionais com poliglactina 910 e com cianoacrilato

Foi realizado estudo morfométrico do cólon descendente de 15 eqüinos hígidos, nove fêmeas e seis machos, submetidos a enterorrafias aposicionais com fio de poliglactina 910 ou com cianoacrilato. Os animais foram distribuídos aleatoriamente em cinco grupos de três animais cada e sacrificados aos três, sete, 14, 35 e 70 dias de pós-operatório para colheita dos segmentos intestinais operados e posterior processamento histológico de rotina. A análise morfométrica foi feita em microscópio óptico adaptado a um sistema de análise de imagens, onde se quantificou o infiltrado inflamatório, mediante contagens de neutrófilos, eosinófilos, macrófagos, linfócitos e plasmócitos, não sendo observadas diferenças (P>0,05) entre as enterorrafias. Houve diferenças significativas entre os dias de pós-operatório para as contagens de neutrófilos, eosinófilos, macrófagos e linfócitos. Também se mensuraram as espessuras das regiões operadas (cicatriz) e das áreas contíguas não operadas (controle), registrando-se diferenças entre os dias de pós-operatório e as regiões (P<0,05), mas não entre as enterorrafias. O fio de poliglactina 910 e o cianoacrilato apresentam a mesma eficácia para serem usados em enterorrafias aposicionais do cólon descendente de eqüinos.