2008, Number 1
Rev Mex Urol 2008; 68 (1)
In non-preserving surgery: the hyperbaric chamber accelerates the time of recovery. Histological and functional evidence with nerves interposed in an experimental model
Figueroa-Granados V, Raquel EO, Venegas AAS, Sánchez CE, Hernández-Pando R
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ABSTRACTThe effect of hyperbaric oxygen (HBO2) therapy on peripheral nerve after its transection and repair, using microsurgical technique, was studied using the rat sciatic nerve model. Following repair, 50 animals were randomly assigned to four groups: 1) No HBO2, sectioned and repaired (n = 10) killed at 7 weeks. 2) HBO2, sectioned and repaired (n = 10) killed at 7 weeks. 3) No HBO2, sectioned and repaired (n = 10) killed at 14 weeks. 4) HBO2, sectioned and repaired (n = 10) killed at 14 weeks. Nerve recovery was assessed by neurophysiological studies (EMG and motor latency) comparing the response before nerve section and after repair, at base line, and after 7 or 14 weeks in all groups. Electromyography was performed comparing HBO2 treated rats and no treated controls after 7 and 14 weeks. Foot-ankle angle response (dorsiflexion) was assessed and histopathology with automated morphometry (axon number, myelin area, blood vessels number) was performed after 7 or 14 weeks. At 7 weeks, motor latency increased significantly in the control non-treated group, whereas amplitude was higher in the HBO2 treated group together with better foot-ankle angle response, higher axons and blood vessels number, and an increase in myelin surface area. After 14 weeks, electromyography showed moderate denervation (90%) and a better foot-ankle angle response in groups treated with HBO2. These results suggest that functional recovery in transected peripheral nerves may be improved by hyperbaric oxygenation following microsurgical repair its aplication can be extended to the radical prostatectomy with sural nerve interposition.