IS THERE NEURAL AND FUNCTIONAL RECOVERY AFTER CLIP REMOVAL IN CERVICAL EXPERIMENTAL SYMPATHECTOMY?
ABSTRACT Background: The surgical treatment of hyperhidrosis by thoracic sympathectomy has brought, in addition to symptomatic relief for many, its main adverse effect: compensatory or reflex sweating. The clipping technique in place of the sympathetic nerve section gave rise to the hope of reversi...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2021-10-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202021000200302&tlng=pt |
| _version_ | 1798019447216144384 |
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| author | Carlos Hespanha MARINHO-JUNIOR Nicolau Gregori CZECZKO Victoria Langer CECHIN Joao Otavio Varaschin ZENI Jurandir Marcondes RIBAS-FILHO |
| author_facet | Carlos Hespanha MARINHO-JUNIOR Nicolau Gregori CZECZKO Victoria Langer CECHIN Joao Otavio Varaschin ZENI Jurandir Marcondes RIBAS-FILHO |
| author_sort | Carlos Hespanha MARINHO-JUNIOR |
| collection | DOAJ |
| description | ABSTRACT Background: The surgical treatment of hyperhidrosis by thoracic sympathectomy has brought, in addition to symptomatic relief for many, its main adverse effect: compensatory or reflex sweating. The clipping technique in place of the sympathetic nerve section gave rise to the hope of reversibility, but the positive results showed to be quite divergent, evidencing the academic deficiency regarding the study of this phenomenon. Aim: To observe micro and macroscopic damage caused by the polymer clip on sympathetic nerve of rabbits seven days after their clipping and the findings after three weeks of clip removal. Method: In this experimental study, 20 rabbits were divided into two groups of 10, group 1 (clipping) and group 2 (de-clipping). The right cervical sympathetic nerve of all animals was clamped with polymeric clip, and in group 2 the nerve was unclipped seven days later. Group 1 rabbits were induced to death on the 7th postoperative day, and group 2 on the 21st after removal of the polymer clip. Macroscopic variables were: clip appearance, presence of discontinuity lesion, infection and adhesions around the nerve. H&E was used in the evaluation of the phases and degree of the inflammatory process and presence of necrosis, and picrosirius red F3BA for quantification of collagen. Results: The cervical sympathetic nerve was intact, without necrosis or infection in all animals of the experiment; there were adhesions in both groups, being minimal in eight animals of each group and moderate or intense in two; the clip was completely closed in all animals at the 7th postoperative day; the inflammatory process shown was chronic, with monomorphonuclear predominance. There was no significant difference between groups regarding the intensity the inflammatory process, but the amount of collagen type I and type III was significantly higher in group 2. Conclusions: The injury caused by the polymer clip on the sympathetic nerve may be reversible, allowing functional return in the areas involved in the simulated cervical sympathectomy. Clipping of the cervical sympathetic nerve using a polymer clip does not cause discontinuity injury. |
| first_indexed | 2024-04-11T16:40:40Z |
| format | Article |
| id | doaj.art-8dd9e4ef24c944a28f2ebd02497265ee |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-04-11T16:40:40Z |
| publishDate | 2021-10-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-8dd9e4ef24c944a28f2ebd02497265ee2022-12-22T04:13:41ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202021-10-0134210.1590/0102-672020210002e1582IS THERE NEURAL AND FUNCTIONAL RECOVERY AFTER CLIP REMOVAL IN CERVICAL EXPERIMENTAL SYMPATHECTOMY?Carlos Hespanha MARINHO-JUNIORhttps://orcid.org/0000-0001-8486-9202Nicolau Gregori CZECZKOhttps://orcid.org/0000-0002-5926-150XVictoria Langer CECHINhttps://orcid.org/0000-0002-3029-763XJoao Otavio Varaschin ZENIhttps://orcid.org/0000-0002-7988-8836Jurandir Marcondes RIBAS-FILHOhttps://orcid.org/0000-0002-5251-7672ABSTRACT Background: The surgical treatment of hyperhidrosis by thoracic sympathectomy has brought, in addition to symptomatic relief for many, its main adverse effect: compensatory or reflex sweating. The clipping technique in place of the sympathetic nerve section gave rise to the hope of reversibility, but the positive results showed to be quite divergent, evidencing the academic deficiency regarding the study of this phenomenon. Aim: To observe micro and macroscopic damage caused by the polymer clip on sympathetic nerve of rabbits seven days after their clipping and the findings after three weeks of clip removal. Method: In this experimental study, 20 rabbits were divided into two groups of 10, group 1 (clipping) and group 2 (de-clipping). The right cervical sympathetic nerve of all animals was clamped with polymeric clip, and in group 2 the nerve was unclipped seven days later. Group 1 rabbits were induced to death on the 7th postoperative day, and group 2 on the 21st after removal of the polymer clip. Macroscopic variables were: clip appearance, presence of discontinuity lesion, infection and adhesions around the nerve. H&E was used in the evaluation of the phases and degree of the inflammatory process and presence of necrosis, and picrosirius red F3BA for quantification of collagen. Results: The cervical sympathetic nerve was intact, without necrosis or infection in all animals of the experiment; there were adhesions in both groups, being minimal in eight animals of each group and moderate or intense in two; the clip was completely closed in all animals at the 7th postoperative day; the inflammatory process shown was chronic, with monomorphonuclear predominance. There was no significant difference between groups regarding the intensity the inflammatory process, but the amount of collagen type I and type III was significantly higher in group 2. Conclusions: The injury caused by the polymer clip on the sympathetic nerve may be reversible, allowing functional return in the areas involved in the simulated cervical sympathectomy. Clipping of the cervical sympathetic nerve using a polymer clip does not cause discontinuity injury.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202021000200302&tlng=ptSympathetic nerveClippingNerve damageSympathetic blockPolymer clipSympathectomy reversalRabbits |
| spellingShingle | Carlos Hespanha MARINHO-JUNIOR Nicolau Gregori CZECZKO Victoria Langer CECHIN Joao Otavio Varaschin ZENI Jurandir Marcondes RIBAS-FILHO IS THERE NEURAL AND FUNCTIONAL RECOVERY AFTER CLIP REMOVAL IN CERVICAL EXPERIMENTAL SYMPATHECTOMY? ABCD: Arquivos Brasileiros de Cirurgia Digestiva Sympathetic nerve Clipping Nerve damage Sympathetic block Polymer clip Sympathectomy reversal Rabbits |
| title | IS THERE NEURAL AND FUNCTIONAL RECOVERY AFTER CLIP REMOVAL IN CERVICAL EXPERIMENTAL SYMPATHECTOMY? |
| title_full | IS THERE NEURAL AND FUNCTIONAL RECOVERY AFTER CLIP REMOVAL IN CERVICAL EXPERIMENTAL SYMPATHECTOMY? |
| title_fullStr | IS THERE NEURAL AND FUNCTIONAL RECOVERY AFTER CLIP REMOVAL IN CERVICAL EXPERIMENTAL SYMPATHECTOMY? |
| title_full_unstemmed | IS THERE NEURAL AND FUNCTIONAL RECOVERY AFTER CLIP REMOVAL IN CERVICAL EXPERIMENTAL SYMPATHECTOMY? |
| title_short | IS THERE NEURAL AND FUNCTIONAL RECOVERY AFTER CLIP REMOVAL IN CERVICAL EXPERIMENTAL SYMPATHECTOMY? |
| title_sort | is there neural and functional recovery after clip removal in cervical experimental sympathectomy |
| topic | Sympathetic nerve Clipping Nerve damage Sympathetic block Polymer clip Sympathectomy reversal Rabbits |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202021000200302&tlng=pt |
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