The Combined Endoscopic Endonasal Far Medial and Open Postauricular Transtemporal Approaches As a Lesser Invasive Approach to the Jugular Foramen: Anatomic Morphometric Study With Case Illustration

2020 ◽  
Vol 19 (4) ◽  
pp. 471-479
Author(s):  
A Samy Youssef ◽  
Gregory D Arnone ◽  
Nyssa Fox Farell ◽  
John A Thompson ◽  
Vijay R Ramakrishnan ◽  
...  
Keyword(s):  
Clinical Case ◽  
Jugular Foramen ◽  
Morphometric Study ◽  
Combined Approach ◽  
Average Volume ◽  
Endoscopic Endonasal ◽  
Invasive Approach ◽  
Lateral Plane ◽  
Group A ◽  
Group B

Abstract BACKGROUND Access to the jugular foramen (JF) requires extensive approaches. An endoscopic endonasal far medial (EEFM) approach combined with a postauricular transtemporal (PTT) approach may provide adequate exposure with limited morbidities. OBJECTIVE To provide a quantitative anatomic comparison of the EEFM, the PTT, and the combined EEFM/PTT approaches. A clinical case of the combined approach is presented. METHODS Five cadaveric heads were dissected. Each specimen received PTT and EEFM approaches on opposite sides followed by an EEFM approach on the side of the PTT approach. Morphometric and quadrant analyses were conducted. Three groups were obtained and compared: PTT (group A), EEFM (group B), and combined (group C). RESULTS Group B had a significantly higher area of exposure of the JF as compared to group A (112.3 and 225 mm2, respectively, P = .004). The average degree of freedom (DOF) in the cranio-caudal plane for groups A and B was 63.6 and 12.6 degrees, respectively (P < .00001). Group A had a higher DOF in the medial-lateral plane than group B (49 vs 13.4 degrees, respectively, P < .00001. The average volume of exposure in groups A and B was 1469.2 and 1897.4 mm3, respectively (P = .02). By adding an EEFM approach to the PTT approach, an additional 56.1% of the anterior quadrant was exposed, representing a 584.4% increase in the anterior exposure. CONCLUSION The PTT and EEFM approaches provide optimal exposures to different aspects of the JF and in combination may constitute a less invasive alternative to the more extensive approaches.

scholarly journals The endoscopic endonasal eustachian tube anterolateral mobilization strategy: minimizing the cost of the extreme-medial approach

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Mohamed A. Labib ◽  
Evgenii Belykh ◽  
Claudio Cavallo ◽  
Xiaochun Zhao ◽  
Daniel M. Prevedello ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Management Strategies ◽  
Jugular Foramen ◽  
Posterior Aspect ◽  
Endoscopic Endonasal ◽  
Surgical Exposure ◽  
Significant Difference ◽  
Management Paradigms ◽  
Group A ◽  
Group B

OBJECTIVEThe ventral jugular foramen and the infrapetrous region are difficult to access through conventional lateral and posterolateral approaches. Endoscopic endonasal approaches to this region are obstructed by the eustachian tube (ET). This study presents a novel strategy for mobilizing the ET while preserving its integrity. Qualitative and quantitative comparisons with previous ET management paradigms are also presented.METHODSTen dry skulls were analyzed. Four ET management strategies were sequentially performed on a total of 6 sides of cadaveric head specimens. Four measurement groups were generated: in group A, the ET was intact and not mobilized; in group B, the ET was mobilized inferolaterally; in group C, the ET underwent anterolateral mobilization; and in group D, the ET was resected. ET range of mobilization, surgical exposure area, and surgical freedom were measured and compared among the groups.RESULTSWide exposure of the infrapetrous region and jugular foramen was achieved by removing the pterygoid process, unroofing the cartilaginous ET up to the level of the posterior aspect of the foramen ovale, and detaching the ET from the skull base and soft palate. Anterolateral mobilization of the ET facilitated significantly more retraction (a 126% increase) of the ET than inferolateral mobilization (mean ± SD: 20.8 ± 11.2 mm vs 9.2 ± 3.6 mm [p = 0.02]). Compared with group A, groups C and D had enhanced surgical exposure (142.5% [1176.9 ± 935.7 mm2] and 155.9% [1242.0 ± 1096.2 mm2], respectively, vs 485.4 ± 377.6 mm2 for group A [both p = 0.02]). Furthermore, group C had a significantly larger surgical exposure area than group B (p = 0.02). No statistically significant difference was found between the area of exposure obtained by ET removal and anterolateral mobilization. Anterolateral mobilization of the ET resulted in a 39.5% increase in surgical freedom toward the exocranial jugular foramen compared with that obtained through inferolateral mobilization of the ET (67.2° ± 20.5° vs 48.1° ± 6.7° [p = 0.047]) and a 65.4% increase compared with that afforded by an intact ET position (67.2° ± 20.5° vs 40.6° ± 14.3° [p = 0.03]).CONCLUSIONSAnterolateral mobilization of the ET provides excellent access to the ventral jugular foramen and infrapetrous region. The surgical exposure obtained is superior to that achieved with other ET management strategies and is comparable to that obtained by ET resection.

The side door and front door to the upper retroclival region: a comparative analysis of the open pretemporal and the endoscopic endonasal transcavernous approaches

2020 ◽  
Vol 133 (6) ◽  
pp. 1892-1904
Author(s):  
Mohamed A. Labib ◽  
Leandro Borba Moreira ◽  
Xiaochun Zhao ◽  
Sirin Gandhi ◽  
Claudio Cavallo ◽  
...  
Keyword(s):  
Selection Process ◽  
Lower Percentage ◽  
Superior Cerebellar Artery ◽  
Endoscopic Endonasal ◽  
Invasive Approach ◽  
Bilateral Group ◽  
Side Door ◽  
Significant Difference ◽  
Group A ◽  
Group B

OBJECTIVEThe pretemporal transcavernous approach (PTA) and the endoscopic endonasal transcavernous approach (EETA) are both used to access the retroclival region. A direct quantitative comparison of both approaches has not been made. The authors compared the technical nuances of, and surgical exposure afforded by, each approach and identified the key elements of the approach selection process.METHODSFourteen cadaveric specimens underwent either PTA (group A) or EETA with unilateral (group B) followed by bilateral (group C) interdural pituitary gland transposition. The percentage of drilled clivus; length of exposed oculomotor nerve (cranial nerve [CN] III), posterior cerebral artery (PCA), and superior cerebellar artery (SCA); and surgical area of exposure of both cerebral peduncles and the pons for the 3 groups were measured and compared.RESULTSGroup A had a significantly lower percentage of drilled area than group B (mean [SD], 35.6% [11.2%] vs 91.3% [4.9%], p < 0.01). In group C, 100% of the upper third of the clivus was drilled in all specimens. Significantly longer segments of the ipsilateral PCA (p < 0.01) and SCA (p < 0.01) were exposed in group A than in group B. There was no significant difference in the length of the ipsilateral CN III exposed among the 3 groups. There was also no significant difference between group A and either group B or group C for the contralateral CN III or PCA exposure. However, longer segments of the contralateral SCA were exposed in group C than in group A (p = 0.02). Furthermore, longer segments of CN III (p < 0.01), PCA (p < 0.01), and SCA (p < 0.01) were exposed in group C than in group B. For brainstem exposure, there was greater exposure of the pons in group C than in group A (mean [SD], 211.4 [19.5] mm2 vs 157.7 [25.3] mm2, p < 0.01) and group B (211.4 [19.5] mm2 vs 153.9 [34.1] mm2, p < 0.01). However, significantly greater exposure of the ipsilateral peduncle was observed in group A (mean [SD], 125.6 [43.1] mm2) than in groups B and C (56.3 [6.0] mm2, p < 0.01). Group C had significantly greater exposure of the contralateral peduncle than group B (p = 0.02).CONCLUSIONSThis study is the first to quantitatively identify the advantages and limitations of the PTA and EETA from an anatomical perspective. Understanding these data may help the skull base surgeon design a maximally effective yet minimally invasive approach to individual lesions.

scholarly journals Video-assisted Minimally Invasive Mitral Valve Surgery versus Conventional Mitral Surgery in Rheumatic Patients

2020 ◽  
Author(s):  
Ayman Badawy ◽  
Mohamed Alaa Nady ◽  
Mohamed Ahmed Khalil Salama Ayyad ◽  
Ahmed Elminshawy
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Invasive Approach ◽  
Video Assisted ◽  
Group A ◽  
Group B

Background: Minimally invasive mitral valve surgery became an attractive option because of its cosmetic advantages over the conventional approach. The superiority of the minimally invasive approach regarding other aspects is still debatable. The aim of our study was to determine the potential benefits of minimally invasive mitral valve replacement with intraoperative video assistance over conventional surgery. Methods: This is a single-center prospective cohort study that included 60 patients with rheumatic heart disease who underwent mitral valve replacement. Patients were divided into two groups: group (A) included patients who had conventional sternotomy (n= 30), and group (B) included patients who had video-assisted minimally invasive mitral valve replacement (n= 30). Intraoperative and postoperative outcomes were compared between both groups. Results: Mortality occurred in one patient in the group (A). Cardiopulmonary bypass time was 118.93 ± 29.84 minutes vs. 64.73 ± 19.16 minutes in group B and A respectively (p< 0.001), and ischemic time was 102.27 ± 30.03 minutes vs. 53.67± 18.46 minutes in group B and A respectively (P < 0.001). Ventilation time was 2.77± 2.27 vs. 6.28 ± 4.48 hours in group B and A respectively (p< 0.001) and blood transfusion was 0.50 ± 0.63 vs. 2.83 ± 1.34 units in group B and A respectively (p< 0.001).  ICU stay was 1.73 ± 0.64 days in the group (B) vs. 4.47 ± 0.94 days in group A (p< 0.001). Postoperative bleeding was 353.33 ± 146.77 ml in the group (B) vs. 841.67 ± 302.03 ml in group A (p <0.001). No conversion to full sternotomy was reported in group B. In group (B), two cases (6.6%) required re-exploration for bleeding vs. four cases (13.2%) in group (A) (p=0.67). The hospital stay was 6.13 ± 1.59 days in the group (B) vs. 13.27 ± 7.62 days in group A (p< 0.001). Four cases (13.3%) developed mediastinitis in group A and in the group (B), there was one case of acute right lower limb embolic ischemia. Conclusion: Video-assisted minimally invasive mitral operations could be a safe alternative to conventional sternotomy with the potential of lesser morbidity and earlier hospital discharge.

scholarly journals Analysis of Peripapillary and Macular Choroidal Thickness in Eyes with Pseudoexfoliative Glaucoma and Fellow Eyes

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Fan Li ◽  
Qingli Shang ◽  
Guangxian Tang ◽  
Hengli Zhang ◽  
Xiaowei Yan ◽  
...  
Keyword(s):  
Choroidal Thickness ◽  
Enhanced Depth Imaging ◽  
Average Volume ◽  
Depth Imaging ◽  
Pseudoexfoliative Glaucoma ◽  
Group A ◽  
Imaging Optical Coherence Tomography ◽  
Group B ◽  
Control Study ◽  
Fellow Eyes

Purpose. To compare differences in peripapillary and macular choroidal thickness in pseudoexfoliative glaucoma (PXG) eyes, nonexfoliative fellow eyes, and normal eyes. Methods. This case-control study included 37 PXG patients (group A: 37 PXG eyes; group B: 37 nonexfoliative fellow eyes) and 37 sex-, age-, and axial length-matched healthy volunteer eyes (group C). Peripapillary and macular choroidal thickness and volume were measured in all subjects via enhanced-depth imaging-optical coherence tomography. Results. The average peripapillary (AP) choroidal thickness was (130.10 ± 46.14) μm, (131.43 ± 46.00) μm, and (147.89 ± 53.32) μm; average macular (AM) choroidal thickness was (191.72 ± 68.07) μm, (204.62 ± 69.54) μm, and (215.10 ± 45.40) μm; and average volume was (0.59 ± 0.21) μm3, (0.63 ± 0.21) μm3, and (0.65 ± 0.14) μm3 in groups A, B, and C, respectively. NIP choroidal thickness was significantly lower in groups A and B than in group C (P<0.05). TIM and TOM choroidal thickness and volume were significantly lower in group A than in group C (P<0.05). NIM, SIM, NOM, IOM, AM choroidal thickness and volume, and CSM choroidal thickness were significantly lower in group A than in group B (P<0.05). CSM, TIM, and TOM in group A and TIM, TOM choroidal thickness, and volume in group B were significantly lower than in group C (P<0.05). Conclusions. NIP choroidal thickness in PXG eyes and nonexfoliative fellow eyes and temporal macular choroidal thickness in PXG eyes were significantly lower than in normal eyes. Macular choroidal thickness (except in temporal regions) was significantly lower in PXG eyes than in nonexfoliative fellow eyes. Changes in peripapillary and macula choroidal thickness further elucidate the choroid’s role in PXG development and progression.

scholarly journals Standardized subannular repair for type IIIb functional mitral regurgitation in a minimally invasive mitral valve surgery setting†

2019 ◽  
Vol 56 (5) ◽  
pp. 968-975 ◽  
Author(s):  
Jonas Pausch ◽  
Eva Harmel ◽  
Christoph Sinning ◽  
Hermann Reichenspurner ◽  
Evaldas Girdauskas
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Functional Mitral Regurgitation ◽  
Invasive Approach ◽  
Type Iiib ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract OBJECTIVES Subannular repair techniques in addition to undersized ring annuloplasty have been developed to address high mitral regurgitation (MR) recurrence rates after mitral valve repair in type IIIb MR. We compared the results of annuloplasty with simultaneous standardized subannular repair versus isolated annuloplasty, focusing on the periprocedural outcomes of minimally invasive procedures. METHODS A consecutive series of 108 patients with type IIIb functional MR with severe signs of bileaflet tethering underwent an annuloplasty + subannular repair (group A; n = 60) versus isolated annuloplasty (group B; n = 48). The primary end point of this prospective, parallel cohort study was death or recurrent MR >2, 1 year postoperatively. The secondary end points were survival and clinical outcomes, with special regard for the minimally invasively treated subgroups. RESULTS Duration of surgery, cardiopulmonary bypass time and aortic cross-clamp time were comparable between both study groups. Procedural outcomes as well as echocardiographic outcome parameters were similar and independent of access (fully endoscopic versus full sternotomy). At the 12-month follow-up, death or MR >2 occurred in 3.3% (2/60) of patients in group A vs in 20.8% (10/48) of patients in group B (P = 0.037). The overall mortality rate during the follow-up period was 1.7% (1/60) in group A vs 12.5% (6/48) in group B (P = 0.041). CONCLUSIONS Standardized realignment of papillary muscles is feasible and reproducible via a minimally invasive approach, resulting in excellent periprocedural outcomes, and has a clear potential to significantly decrease MR recurrence and improve 1-year outcomes compared to isolated annuloplasty.

Endoscopic endonasal dacryocystorhinostomy vs nasolacrimal duct intubation in pediatric nasolacrimal duct obstruction - a comparative study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rana Atia ◽  
Magda Samy ◽  
Sheriff Elwan ◽  
Thanaa Helmy ◽  
Ashraf Shaat ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Success Rate ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Endoscopic Endonasal ◽  
Duct Obstruction ◽  
Tube Removal ◽  
Group A ◽  
The Difference ◽  
Group B

Abstract Study design; Pilot randomized controlled study. Objective To compare success rates of endoscopic endonasal dacryocystorhinostomy and nasolacrimal duct intubation in congenital nasolacrimal duct obstruction (NLDO) in a trial to define the superiority of either technique. Patients & Methods Sixty-six eyes of 61 patients were diagnosed as having epiphora and mucopurulent discharge due to congenital NLDO. The patients were randomly divided into two groups; Group A; 33 eyes of 28 patients (treated by probing and silicone intubation only (NLDI)) and Group B; 33 eyes of 33 patients (treated by endoscopic endonasal dacryocystorhinostomy and silicone tube intubation (EDCR). All tubes were removed 6 months after the operation. Results The success rate, defined as complete resolution of clinical symptoms and signs after 6 months of follow up, was 72.7 % in Group A and 81.8% in Group B. Although the success rate was higher in Group B, yet the difference was shown to be statistically nonsignificant. Preoperative symptoms were assessed postoperatively after tube removal. Complete cure had a higher rate of occurrence in Group B than in Group A (27eyes (81.8%) versus 25 eyes of 22 patients (75.8%) respectively). Postoperative positive fluorescein dye disappearance test (FDDT) after tube removal was more in Group B than in Group A (27 eyes (81.8) versus 24 eyes of 21 patients (72.7 %) respectively). In Group A, silicone tubes had to be repositioned due to prolapse in 3 eyes of 3 patients (9.1%) and had to be removed early in 3 eyes of 3 patients (9.1%) due to failure of repositioning. In Group B, silicone tubes did not require early tube extraction before the date of removal in any of the patients. Intraoperative, there was only one case (3.0%) of fat prolapse during EDCR in Group B with no subsequent postoperative complications. Hemostasis did not represent a problem in any of the patients. Postoperative complications occurred more in Group B than Group A (21 eyes (63.6%) versus 13 eyes of 13 patients (39.4 %) respectively). Late complications occurred more in Group B than Group A (18 eyes (54.5%) versus 12 eyes of 12 patients (36.4%) respectively) in the form of persistent epiphora and tube prolapse. Conclusion The success rate of pediatric EDCR was higher than that of pediatric NLDI. The difference was statistically non-significant. Complications were comparable between the two groups. The study, being pilot in its comparative aspect between endoscopy and intubation, opens the horizon for further study on a larger group that probably will expand this difference.

An Alternative, Less Invasive Approach to Median Sternotomy for Cardiac Operations in Adults: Right Infra-Axillary Minithoracotomy

2005 ◽  
Vol 33 (1) ◽  
pp. 77-83 ◽  
Author(s):  
B Tünerir ◽  
R Aslan
Keyword(s):  
Mitral Valve ◽  
Open Heart Surgery ◽  
Median Sternotomy ◽  
Valve Disease ◽  
Invasive Approach ◽  
Less Invasive ◽  
Postoperative Blood Transfusion ◽  
Group A ◽  
Group B ◽  
Cardiac Operations

We compared the use of right infra-axillary minithoracotomy and conventional median sternotomy in direct open-heart surgery in 59 adults undergoing elective surgery for mitral valve stenosis, mitral valve disease, atrial septal defect repair, left atrial myxoma excision or mitral and tricuspid valve disease. Patients were randomized to the infra-axillary minithoracotomy group (Group A; n = 29) or the median sternotomy group (Group B; n = 30). Post-operative outcomes (post-operative bleeding; cross-clamp time; length of hospital and intensive care unit stays; and postoperative blood transfusion and analgesic requirements) were recorded and compared; they were found to be significantly lower in Group A than Group B. We concluded that right infra-axillary minithoracotomy is less invasive and can be used safely in adults as an alternative approach to conventional median sternotomy for some cardiac operations. Further multicentre studies in adults are now needed.

Stentless mirrored L-shaped septonasal flap versus stented flapless technique for endoscopic endonasal repair of bilateral congenital choanal atresia: a prospective randomised controlled study

2018 ◽  
Vol 132 (4) ◽  
pp. 329-335 ◽  
Author(s):  
M O Tomoum ◽  
M H Askar ◽  
M F Mandour ◽  
M A Amer ◽  
M E Saafan
Keyword(s):  
Choanal Atresia ◽  
Controlled Study ◽  
Endoscopic Repair ◽  
Endoscopic Endonasal ◽  
Randomised Controlled Study ◽  
Group A ◽  
Choanal Stenosis ◽  
Group B ◽  
Randomised Controlled ◽  
Endoscopic Assessment

AbstractObjectives:To compare the outcomes of endoscopic repair of bilateral congenital choanal atresia using a flap technique without stenting versus endoscopic repair using stenting without a flap.Methods:A prospective randomised controlled study was conducted, comprising 72 patients with bilateral congenital choanal atresia. The patients were randomised into two groups. Group A (42 patients) underwent endoscopic repair using a mirrored L-shaped flap without stenting, and group B (30 patients) underwent endoscopic repair using stenting without a flap.Results:At a mean follow-up period of 18.2 months, endoscopic assessment revealed a patent posterior choana in 81 per cent and 83.33 per cent of patients in group A and group B respectively. Choanal stenosis occurred in 21.40 per cent and 33.33 per cent of patients in group A and group B respectively. Granulation tissue was observed in 28.6 per cent and 53.3 per cent of patients in group A and group B respectively.Conclusion:The endoscopic approach utilising a flap without stenting is safe and effective, with a high success rate.

scholarly journals Morphometric study of the isthmus of the thyroid gland in Bangladeshi cadaver

2013 ◽  
Vol 2 (2) ◽  
pp. 81-84
Author(s):  
Abu Sadat Mohammad Nurunnabi ◽  
S Mahbub ◽  
HA Perven ◽  
S Ara
Keyword(s):  
Thyroid Gland ◽  
Age Groups ◽  
Morphological Difference ◽  
Tracheal Ring ◽  
Human Thyroid ◽  
Morphometric Study ◽  
Cross Sectional ◽  
Group A ◽  
The Difference ◽  
Group B

Background: The position and size of isthmus of thyroid vary greatly in humans, and sometimes it is absent. The present study was designed to find out the difference in isthmus of the thyroid gland of Bangladeshi people in relation to age and sex. Methods: The cross-sectional, descriptive study was performed in the Department of Anatomy, Dhaka Medical College, Dhaka, from January to December 2008, on 73 post mortem human thyroid gland collected from unclaimed dead bodies. Isthmus was found in 60 cases. The samples having the isthmus (n=60) were divided into three age-groups including group A (10-20 years), group B (21-50 years) & group C (>50 years) and the isthmus was cut off from the thyroid gland, then its length, breadth and thickness were measured and recorded. Results: The isthmus of the thyroid gland was found in 82.2% cases. It extended from 2nd to 4th tracheal ring in 91.7% and from 2nd to 5th ring in 8.3% cases. No difference was found in length, breadth and thickness of the isthmus of the thyroid gland in between males and females. However, difference was found in breadth between group A & B (p<0.05) and A & C (p<0.01) and in thickness between group B & C (p<0.05). Conclusion: The presence or absence, positional change and variation in gross dimension of the thyroid isthmus were evident in humans. The morphological difference was found with increasing age but not with sex. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 81-84 DOI: http://dx.doi.org/10.3126/njms.v2i2.8940

scholarly journals Morphometric study of gastric mucosa in dogs submitted to proximal gastric vagotomy, splenectomy or proximal gastric vagotomy associated with splenectomy

2002 ◽  
Vol 17 (5) ◽  
pp. 289-298 ◽  
Author(s):  
Carlos Augusto Real Martinez ◽  
Jaques Waisberg ◽  
Rogério Tadeu Palma ◽  
Fabiana Zangiácomo da Silva ◽  
Gustavo Cimerman ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Morphometric Study ◽  
Proximal Gastric Vagotomy ◽  
Mucous Surface ◽  
Computerized Morphometry ◽  
Group A ◽  
Total Splenectomy ◽  
Group B ◽  
Gastric Mucous ◽  
Group D

OBJECTIVE: The aim of the present study was to evaluate the effects of total splenectomy and proximal gastric vagotomy (PGV) isolated or associated to the vascularization of the stomach. METHODS: Twenty-eight dogs were distributed in: group A - animals undergoing laparotomy and gastric manipulation; group B - animals undergoing PGV; group C - animals undergoing PGV and splenectomy; and group D - animals undergoing splenectomy alone. All animals were sacrificed on the 7th postoperative day, and immediately followed by infusion of xanthene dye into the thoracic aorta. On the gastric mucous surface, the formation of stained areas and other areas lacking staining was measured by millimeter squares, planimetry and the computerized morphometry method. RESULTS: The formation of an area lacking in staining along the lesser gastric curvature was seen in all animals of groups B and C, which was significantly increased in group C, although in groups A and D such areas were not observed. CONCLUSION: These results showed that, in animals with splenectomy, the vascularization of the stomach was capable of perfusing the whole organ surface, but in animals with PGV alone or associated with splenectomy there was a notable decrease in blood supply throughout the area of the lesser gastric curvature, which suggests the ischemic impairment of this region.

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