[One layer sutures of digestive tract knotted in the lumen, in dogs: perforating stitch versus serosubmucosal suture].
OBJECTIVE
To compare hand sewn digestive tract single layer anastomosis with knots tied in the lumen: total stitches versus serosubmucosal.


METHODS
Six mongrel dogs were submitted to laparotomy, each one with two transversal jejunum sections, 30 and 70 cm far from Treizt angle and suture, serosubmucosal and total stitches, both with knots tied in the lumen, over the mucosa, at the posterior wall. After slaughter (7th post-operative day) was evaluated the peritoneal adhesions at posterior wall. The macro and microscopic features was observed. Wilcox on rank sum test was applied for the histhometry.


RESULTS
More profuse adhesions with the serosubmucosal stitches tied in the lumen with adherence tissue over the suture line, avoiding the serosa, within or without healing deformation of the suture lines, doing an anastomosis angle. There was good serosa reconstitution with total stitches. The epithelium was perfectly reconstituted at serosubmucosa, but not at total stitches, where was residual focus of acute inflammation. The reline and regeneration of wall components (except the serosa, whose regeneration was impaired by peritoneal adherences) were better with serosubmucosal then total stitches. The muscularis never regeneration in anyone suture. The polimorphonuclear cells, macrophages, fibroblasts, and collagen fibers was more numerous (statistical significance) at total stitches.


CONCLUSIONS
Total stitches with knots tied in the lumen, at posterior wall, over the mucosa are safe full, despite of major inflammation. Serosubmucosal with knots tied in the lumen, at posterior wall, over the mucosa, allows peritoneal adherences formation, and should be avoided.
Azevedo
João Luiz Moreira Coutinho
JL
Laboratório da Disciplina de Técnica Operatória da Universidade Federal de São Paulo. Jozevedo.dcir@epm.br
Da Silva
Cássio Edvan Paulino
CE
Azevedo
Otávio Cansanção
OC
Simões
Manoel De Jesus
Mde J
D000818:Animals; D013505:Digestive System Surgical Procedures; D004285:Dogs; D008297:Male; D009092:Mucous Membrane / Q000601:surgery; D013536:Suture Techniques; D014945:Wound Healing