RESUMO
BACKGROUND: It is possible to resect the perforated segment and reestablish intestinal continuity with adequate morbidity and mortality results in patients with complicated diverticulitis. AIMS: To evaluate the type of surgery performed at our center and the results of the procedures in patients with complicated diverticulitis. MATERIAL AND METHODS: All patients that underwent sigmoidectomy due to complicated diverticulitis within the time frame of 2005-2012 were included in the study. The primary objective was to evaluate the type of surgery performed. The secondary objective was to evaluate patient morbidity and mortality after 30 postoperative days. RESULTS: The study included 77 patients with a mean age of 51.17±12.80 years. The majority of the patients were men (64.9%) (n=50) and the mean BMI was 28.24±4.06kg/m2. A total of 63.6% (n=49) patients presented with a Hinchey iii-iv classification. Sigmoidectomy with primary anastomosis was performed in 58.4% (n=45) of the patients, 48.8% (22/45) of whom presented with Hinchey iii-iv. Primary anastomosis was more frequently performed in patients that had Hinchey i-ii(P=.001). Open surgery was carried out in 85.7% (n=66) of the cases. The mean surgery duration was longer in the patients with primary anastomosis (181.73±68.2min vs. 152.13±65.8min) (P>.05). Colorectal surgeons performed the procedures in 44.2% (n=34) of the cases. Complications presented in 23.4% (n=18) of the patients and there was a tendency toward more complications in patients that underwent the Hartmann's procedure. The mortality rate was 2.6% (n=2). CONCLUSIONS: Sigmoidectomy with primary anastomosis is a frequent surgery in patients with complicated diverticulitis at our hospital. There was no difference in morbidity and mortality, compared with the Hartmann's procedure.
Assuntos
Colectomia/métodos , Colo Sigmoide/cirurgia , Doença Diverticular do Colo/cirurgia , Doenças do Colo Sigmoide/cirurgia , Adulto , Idoso , Anastomose Cirúrgica , Colectomia/mortalidade , Doença Diverticular do Colo/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Doenças do Colo Sigmoide/complicações , Doenças do Colo Sigmoide/mortalidade , Resultado do TratamentoRESUMO
BACKGROUND: The quality of the presentation of a free paper in a medical congress is not necessarily related to the quality of the methodology. OBJECTIVE: To analyze the quality of the presentation of the free papers in the National Congress of Gastroenterology in Mexico (Morelia-1997). METHODS: A prospective study was designed to evaluate the following aspects: Limitation to time assigned, adequate use and design of slides, and mentioning of the main methodologic characteristics. RESULTS: There was a high quality of presentation in the majority of papers. The most frequent problems identified, amenable to improvement, were non-limitation to assigned time (24%), as well as problems in the design of slides (too many lines/columns in 32% and excessive number in 23%). CONCLUSIONS: The knowledge of the results may help to improve the presentations of the free papers in the national congresses of gastroenterology.
Assuntos
Gastroenterologia/normas , Pesquisa/normas , Congressos como Assunto , México , Estudos ProspectivosRESUMO
OBJECTIVES: To analyze the clinical presentation, and diagnostic and therapeutic implications in patients with retro-rectal tumors. METHODS: This paper reports two patients. Both patients had constipation and change in bowel habits, and the physical examination revealed the retro-rectal neoplasia. One of the patients had rectal intra-luminal invasion due to a schwannoma and underwent a transanal excision, with subsequent recurrence that required a combined abdomino perineal resection due to invasion of the tumor to the anorectal angle. The second patient had a teratoma and had a good outcome after a trans-sacral resection of the neoplasia. CONCLUSIONS: Clinical suspicion is imperative to diagnose these rare tumors. Treatment of choice is complete resection of the tumor. Localization of the neoplasia, as evidenced by image studies will help to decide the best surgical approach.
Assuntos
Neurilemoma , Neoplasias Retais , Teratoma , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurilemoma/patologia , Neurilemoma/cirurgia , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Reto/patologia , Teratoma/patologia , Teratoma/cirurgiaRESUMO
BACKGROUND: Anorectal fistulas test the performance and experience of colon and rectal surgeons. PURPOSE: This review paper was performed to discuss the most recent advances in the diagnosis and treatment of complex anorectal fistulas. RESULTS: Failures to treatment of anorectal fistulas may be reduced only by fully knowledge of the anorectal anatomy, and all the possible routes that the fistulas could go through. Their complexity is directly related to their relationship with the anal sphincter, which should be considered by the surgeon in order to take care of the perfect identification and localization of their origin. Treatment should be individualized to each patient. CONCLUSIONS: The role of the diverse surgical alternatives will depend upon the characteristics and relationships of the fistulous tract and the sphincter.