Key words: Models; Education. Anastomosis; Surgical. Gastroenterostomy. Laparoscopy

Dietary supplementation with pterostilbene (PS) and/or a probiotic (PRO) may ameliorate the intestinal microbiota in disease conditions. This study aims to evaluate PS and PRO for the chemoprevention of putative precursor lesions for colorectal cancer (CRC) in an experimental model of intestinal carcinogenesis with 1,2-dimethylhydrazine (1,2-DMH). Sixty male Wistar rats were equally divided into five groups: Sham, 1,2-DMH, 1,2-DMH + PS, 1,2-DMH + PRO, and 1,2-DMH + PS + PRO. PRO (5 × 10⁷/mL) was offered in water, and PS (300 ppm) was provided in the diet ad libitum. 1,2-DMH (20 mg/kg/week) was administered for 15 consecutive weeks. In the 25th week, proctocolectomy was conducted. PRO alone and PRO combined with PS were the best intervention strategies to improve experimental 1,2-DMH-induced CRC regarding several parameters of carcinogenesis. Our findings may contribute to the development of novel preventive strategies for CRC and may help to identify novel modulators of colon carcinogenesis.

Key words: Education, Medical; Simulation Training; Anastomosis, Surgical; Laparoscopy; hecklist

To analyze the potential of tumor necrosis factor-α (TNF-α) and factor nuclear kappa B (NF-κB) as colorectal cancer (CRC) biomarkers in an experimental model of intestinal carcinogenesis with 1,2-dimethyhydrazine (1,2-DMH).

Background and study aims: Malignant gastric outlet obstruction (MGOO) is a debilitating condition requiring effective palliation. Surgical gastrojejunostomy (SGJ) has been the traditional standard but is associated with relevant morbidity. Endoscopic ultrasound–guided gastroenterostomy (EUS-GE) has emerged as a minimally invasive alternative, though comparative efficacy and safety remain incompletely defined. This systematic review and meta-analysis compared EUS-GE and SGJ for palliative management of MGOO. Methods: This review was registered in PROSPERO (CRD420261283768). MEDLINE, Embase, Cochrane CENTRAL, Scopus, and LILACS were searched from January 2015 to October 2025. Random-effects meta-analyses were performed using risk ratios for technical and clinical success, odds ratios for adverse events, serious adverse events, symptom recurrence, reintervention, and 30-day mortality, and mean differences for length of hospital stay. Prespecified subgroup and sensitivity analyses were conducted to assess the robustness of findings. Results: Ten studies (2 randomized trials and 8 observational studies) including 1,087 patients (659 EUS-GE, 428 SGJ) were analyzed. Technical success was comparable between groups. EUS-GE was associated with higher clinical success (RR 1.06; 95% CI 1.01–1.12), fewer overall AE (OR 0.35; 95% CI 0.22–0.56) and SAE (OR 0.52; 95% CI 0.28–0.93). EUS-GE resulted in lower symptom recurrence (OR 0.39; 95% CI 0.18–0.85) and shorter LOS (mean difference −4.11 days; 95% CI −5.29 to −2.92). Reintervention rates and 30-day mortality were similar. Conclusions: EUS-GE is a safe and effective minimally invasive alternative to SGJ for palliation of MGOO. These findings support the growing role of EUS-GE as a preferred palliative strategy in specialized centers.

Introdução: em algumas situações, o trauma abdominal contuso com lesão renal ou esplênica pode ser conduzido com tratamento não operatório (TNO). Uma lesão simultânea de rim e baço não apresenta uma conduta padrão e existem situações limítrofes que necessitam de maior discussão. Relato de caso: paciente com lesão renal complexa e hemoperitônio secundário a lesão esplênica que teve boa evolução após compensação clínica do sangramento. Conclusão: o TNO de lesões combinadas do rim e do baço pode ser possível em algumas situações.