[Changes in the gastric mucosa after iso- and anisoperistaltic gastrojejunostomy in rats].
Gastrojejunostomies are frequently associated to postoperative manifestations, provoked by biliopancreatic reflux to the stomach. Not only the symptoms can be severe, but also regenerative and reactional transformations of the gastric epithelium, dysplastic alterations and perianastomotic ulcers may be formed. Changes of gastric mucosa and their relation to surgical iso and anisoperistaltic gastrojejunal anastomosis were carried out. Gastrojejunostomies non associated with gastrectomy were performed in two groups (n = 7) of Holtzman rats. In the 30th postoperative day, the stomach and the jejunum close to the anastomosis were removed for pathohistological study. The group with anisoperistaltic anastomosis had a greater extension of histological alterations compatible with the histological picture of reflux gastropathy than the isoperistaltic group (P < 0.05). Three anastomotic ulcers were identified in the anisoperistaltic group and only one in the isoperistaltic, but these results were not statistically significant. Among the gastric surgeries, the gastrojejunostomies are the ones which cause greater biliopancreatic reflux. This reflux may induce changes in the gastric mucosa close to the anastomosis and even lead to cancer. According to other papers, the amount of reflux to the stomach can be directly related to the histological alterations on its mucosa. In conclusion, the anisoperistaltic gastrojejunostomy causes more changes in the gastric mucosa than the isoperistaltic, in this experimental model.
Trapiello Neto
V
V
Departamento de Cirurgia da Faculdade de Medicina da Universidade Federal de Minas Gerais--UFMG, Belo Horizonte.
dos Santos
B M
BM
Petroianu
A
A
Barbosa
A J
AJ
D000714:Anastomosis, Surgical; D000818:Animals; D001655:Bile Reflux / Q000209:etiology*; D005753:Gastric Mucosa / Q000473:pathology*; D005774:Gastrostomy / Q000009:adverse effects* / Q000379:methods; D007582:Jejunostomy / Q000009:adverse effects* / Q000379:methods; D010528:Peristalsis; D011183:Postoperative Complications; D051381:Rats; D017207:Rats, Sprague-Dawley