Rectosigmoidectomía perineal: alternativa quirúrgica inevitable en el prolapso rectal total irreductible / Perineal rectosigmoidectomy: one surgical alternative for complete and non reducible rectal prolapse

El prolapso rectal es la protrusión circunferencial de todo el espesor de las paredes del recto a través del esfínter anal. Cuando es irreductible y con estados de comorbilidad significativos asociados se plantea la opción del abordaje perineal al abdominal. Una serie de 6 pacientes a los que se le practicó una rectosigmoidectomia perineal, en el contexto de taras clínicas importantes indica que este abordaje es válido para solucionar quirúrgicamente el prolapso con una tasa de morbilidad y mortalidad bajas.

The rectal prolapse is the circumferential protrusion of the entire thickness of the rectal wall through the anal sphincter. When it is irreductible and with significant morbidity an option of the perineal approach is preferred over the abdominal approach. A series of six patients who have undergone perineal rectosigmoidectomy, in situations of major clinical conditions, indicates that this approach is valid to resolve surgically the prolapse, with a low morbidity and mortality outcome.

Spasmolytic effect of constituents from Lepechinia caulescens on rat uterus.

Lepechinia caulescens Ortega Epling (Lamiaceae) is a perennial herb used in Mexican folk medicine to treat diabetes, hypertension, gastrointestinal infections, dysmenorrhea and as abortifacient. In this study, a bioassay-guided fractionation of the hexanes extract of the leaves, evaluating the capacity to relax contraction of rat uterus rings induced by KCl (60mM), was made. The results indicated that, from the four isolated terpenes, spathulenol (1) was the most potent spasmolytic agent, followed by methyl 9alpha,13alpha-epidioxyabiet-8(14)-en-18-oate (2), 9alpha-hydroxydehydroabietyl alcohol (4) and dehydroabietic acid (3) studied at 10 and 30 microg/mL. The spasmolytic activity of 1 was totally reverted by addition of increasing extracellular Ca2+ concentrations ([Ca2+]o), while incubation of uterus rings with 1 in calcium free solutions reduced the contraction produced by [Ca2+]o in a concentration-dependent manner. Moreover, the presence of L-NAME (100 microM) or propranolol (10 microM) did not block the spasmolytic effect. These results suggest that 1 induces a greater blocking action on voltage-operated calcium channels. EtOAc and MeOH extracts of the leaves, which showed slight relaxing activity, led to 4 and rosmarinic acid (5).