Preventing complications in colorectal anastomosis: results of a randomized controlled trial using bioabsorbable staple line reinforcement for circular stapler.

Background: Anastomotic complications, including leaks, stenoses, and bleeding, cause considerable mortality and morbidity after colorectal surgery.

Objetive: The purpose of this work was to evaluate the effectiveness of bioabsorbable staple line reinforcement in reducing colorectal anastomotic complications.

Design: This was a prospective randomized clinical study.

[Radiation proctitis and chronic and refractory bleeding. Experience with 4% formaldehyde].

Introduction: Bleeding is a common complication of proctitis secondary to radiotherapy of pelvic tumours. Between 5 and 10% may become severe and refractory to topical and endoscopic treatment. Experience with the application of 4% formaldehyde is presented.

Patterns of local recurrence in rectal cancer after a multidisciplinary approach.

Improvements in surgery and the application of combined approaches to fight rectal cancer have succeeded in reducing the local recurrence (LR) rate and when there is LR it tends to appear later and less often in isolation. Moreover, a subtle change in the distribution of LRs with respect to the pelvis has been observed. In general terms, prior to total mesorectal excision the most common LRs were central types (perianastomotic and anterior) while lateral and posterior forms (presacral) have become more common since the growth in the use of combined treatments.

[Surgical approach to the locoregional recurrence of cancer of the rectum].

A literature review has been made on the pelvic recurrence of rectal cancer using the MedLine, Ovid, EMBASE, Cochrane and Cinahl data bases. Assessment of the locoregional recurrence must be made using imaging tests in order to rule out the presence of metastasis, as well as for locating its exact location within the pelvis. As the only curative treatment should be complete resection of the recurrence with negative margins, a pre-operative CT, NMR, endorectal ultrasound and PET-CT must be performed to determine its resectability.

[Benign anastomotic strictures after oncologic rectal cancer surgery. Results of treatment with hydrostatic dilation].

Introduction: Benign anastomotic strictures after rectal cancer surgery are common and their treatment can vary from conservative measures to surgical resection.

Patients And Methods: Between March 2001 and August 2008, 422 patients with rectal cancer underwent anterior resection and 83.8% were treated with primary anastomosis.

[Ventral rectal sacropexy (colpo-perineal) in the treatment of rectal and rectogenital prolapse].

Introduction: Ventral sacral-rectopexy with mesh corrects rectal prolapse and minimises rectal dissection. Subsequent colpopexy corrects apical and posterior prolapses of the vagina. The combination of both procedures can lead to the simultaneous correction of pelvic organ prolapses (POP).

[A single rectal diclofenac dose reduces post-haemorrhoidectomy urine retention: results of a randomised, controlled clinical study].

Introduction: Post-surgical urinary retention requiring a catheter has a mean incidence of 15% (1% to 52%) in the post-operative period after anal surgery. The primary objective of this study was to assess the efficacy of topical rectal Diclofenac in reducing post-surgical haemorrhoidectomy urinary retention. Its impact on the reduced need for post-surgery analgesia has also been assessed as a secondary objective.

[Perineal cutaneous metastases from adenocarcinoma after surgery for colorectal cancer].

The development of cutaneous metastases in the context of colorectal cancer is exceptional, especially in the absence of visceral lesions. We present the case of a 50-year-old woman who underwent surgery for a T3N0M0 tumor in the sigmoid colon, with resection of ovarian metastases at 12 months. Reoperation was performed 14 months later for local anastomotic recurrence.

[Initial response to topical diltiazem can predict outcome of chronic anal fissure].

Introduction: In the last few years, the medical treatment of chronic anal fissure (chemical sphincterotomy) has been introduced as a consequence of the morbidity attributed to surgical sphincterotomy. However, medical treatment has two disadvantages: moderate effectiveness (between 30% and 80%) and the need for treatment to be prolonged for more than 8 weeks.

Objective: To evaluate initial response to topical diltiazem 2% topical gel as a predictive factor in the curability of chronic anal fissure.

[Surgical treatment of rectocele and enterocele: an integrated view of disorders of the posterior vaginal compartment].

Genital prolapse, whether associated or not with urinary, anal or sexual dysfunction, should be evaluated globally to select the appropriate treatment. Rectocele and enterocele are defects of the posterior vaginal compartment, although they can be secondary to abnormalities of the central compartment, since lesions of the perineal raphe and rectovaginal septum can occur in isolation or accompanied by others that also affect the tissues involved in pelvic support. The various surgical approaches to rectocele alone or associated with other defects are reviewed.