[ colon-anal anastomosis with temporary protective colostomy for lower rectal tumors following preoperative radiotherapy]

The aim of this study was to evaluate the local experience in preserving the anal sphincter in patients with low rectal tumors using manual colo-anal anstomosis, protected with a temporary colostomy, after a preoperative course of radiotherapy. Fourty-two [42] patients were followed up in our teaching hospitals included in this study, during the period between 1999 and 2002. Their tumors was lower than 15 cm from anal sphincter [<15cm] on the rigid sigmoidoscope, these patients were divided into three groups: the first group: 7 patients in whom the lower edge of the tumor was 5 cm from the anus, they were given preoperative course of radiotherapy. The second group: 15 patients, in whom the tumor was 5-7 cm from the anus, they were also given a course of preoperative radiotherapy. The third group: 20 patients, their tumor was higher than 8 cm from the anus, they had immediate surgical treatment without radiotherapy prior to surgery. The interim period between surgery and radiotherapy was 30 days, and patients were given 40 gray during three weeks. Patients were followed-up for [8-48] months, there was no deaths, no fistula and no perineal infection during the convalescence period, there was left colon necrosis in one case, and early stenosis in the anastomosis in another. Local recurrence was evident in five patients; it was controlled in one case by abdomino-perineal resection. The functional results, were good in 66.6% after two years of follow-up. The patients had an average of three stools per day after one year, the average of total survival rate for four years was 83.3%. It is possible to preserve the anal sphincter with low colo-anal anastomosis for the treatment of tumors of the lower third of the rectum with the help of a preoperative radiotherapy, with good results on the functional and canerous levels, as an alternative treatment to abdomino-perineal resection in selected patient

Anastomosis intestinal en un sólo plano / Intestinal anastomosis in a level only

Quince niños con edades comprendidas entre 0 y 10 años, fueron operados de resección intestinal con anatomosis en un solo plano, en el Servicio de Cirugía Pediátrica del Hospital Universitario "Dr. Antonio Pineda", de la Ciudad de Barquisimeto; entre el lapso comprendido de mayo de 1993 a febrero de 1995. se utilizó la técnica de puntos separados en "U" con bordes invaginados. La mediana de hospitalización fue 5 días. No hubo complicaciones inherentes a la técnica en estudio; concluyéndose que es segura y confiable

Protector de anastomosis colo-recto-anales / Intestinal anastomosis protector

Presentamos un trabajo de investigación clínica de protección de anastomosis colo-colónica, colo-rectal, y colo-anal, con la colocación endoluminal de un preservativo que se fija al cabo proximal y se desliza al cabo distal para proteger el sitio anastomótico durante los primeros 10 o 15 días, impidiendo durante ese tiempo el contacto de la materia fecal con la línea de sutura. Cumplido dicho plazo el preservativo se elimina espontáneamente por el ano. Colocamos el protector en 39 anastomosis: 12 colo-cólicas, 25 colo-rectales y 2 colo-anales, sin morbi-mortalidad. En el 90 por ciento las cirugías fueron programadas y en el 10 por ciento restante de urgencia