Use of the Monti principle for constructing a continent gastrostomy.
OBJECTIVE
To research technical alternatives for permanent gastrostomy that minimizes the drawbacks and complications reported by several authors.


METHODS
An experimental model was developed where the material was divided into 2 groups: the study group (SG) composed of 12 half-breed dogs where the proposed technique was applied, and the control group (CG) composed of 10 animals where a gastrostomy as proposed by Webster in 1974 was applied. On the 90th postoperative day, both groups underwent tests for assessing competence concerning leakage. These were performed under general anesthesia and following sacrifice.


RESULTS
In the SG, under anesthesia only one animal had leakage through the gastrostomy. Following sacrifice, leakage was observed in 2 animals. In the CG, under anesthesia, 2 animals had leakage and, following sacrifice, only 1 animal did not present leakage. On histopathological analysis of the SG, gastric mucosa was evidenced around the jejunal tubes, with normal features, moderate inflammatory mononuclear infiltrate in jejunal tubes and only slight infiltrate around the gastrostomy stoma. In the CG, ulceration was constant around the external stoma of the gastrostomy tubes. In the corium, the inflammatory infiltrate was less intense than in the SG. The SG proved to be more efficacious than the CG concerning leakage, and this efficacy is attributed to the submucous valvular system.


CONCLUSIONS
The featured technique showed competence concerning leakage, allowing its clinical applicability as an alternative for permanent gastrostomy.
Araujo
Luiz A P
LA
Divisions of Pediatric Surgery and Urology, Center of Experimental Surgery, Federal University of Pernambuco, Recife, Pernambuco, Brazil. luizal12@terra.com.br
Brandt
Carlos T
CT
Lima
Salvador V C
SV
Vilar
Fabio O
FO
Araujo
Andre A P
AA
D000818:Animals; D003251:Constriction, Pathologic / Q000209:etiology; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004285:Dogs; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D023421:Models, Animal; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D015203:Reproducibility of Results