[Antibiotic prophylaxis in colorectal surgery]. / Profilaxis antibiótica en cirugía colorrectal.

The literature of infections after colo-rectal surgery is reviewed, including the influence of mechanical preparation and the prophylactic use of various antibiotic combinations, orally or parenterally. Is is concluded that appropriate prophylaxis is mandatory. Third generation cephalosporins singly or in combination seem to give the best results in the majority of reports. They are economically justified as prophylaxis with antibiotics decreases hospital costs.

[Cancer of the colon with a duodenal fistula. Its surgical treatment]. / Cáncer de colon fistulizado a duodeno. Su tratamiento quirúrgico.

The authors present an infrequent case: fistulization of a colonic cancer to duodenum. A side from its rarity, the case is interesting from the surgical point of view. Not many years ago, the fact that carcinoma of the hepatic angle had infiltrated the duodenum was interpreted as a sign of nonresectability. Now prognosis is not considered to depend on this complication, but instead, on tumoral stage, as in any other colonic tumor. The ideal technique is block resection, which requires enlarged right hemicolectomy and partial excision of the duodenum, if possible, or cephalic duodenopancreatectomy in selected cases. Although appreciable survival rates have been reported in this situation, the most important benefit may be an improved quality of life for the patient if resection is not curative.

[Decrease in postoperative mortality caused by bleeding peptic ulcer]. / Descenso de la mortalidad postoperatoria de la úlcera péptica sangrante.

Hemorrhage continues to be a serious complication of peptic ulcer, especially in patients over 65 years. Gastric location, delay in the surgical intervention, the amount and characteristics of hemorrhage and the use of laborious resection techniques are factors that worsen the prognosis and contribute to increased mortality. In the authors' experience, the comparison of two series separated in time led them to conclude that restriction of the use of resection techniques for gastric ulcers and improved medical-surgical collaboration, facilitated by use of a special protocol for bleeding peptic ulcers, has reduced mortality from 12.5% to 4.08% in 49 patients operated in the last 3 years.