[Clinical results of loop ileostomy closures in rectal cancer surgical patients. Effect of chemotherapy in the waiting period]. / Resultados clínicos del cierre de ileostomías en asa en pacientes intervenidos de cáncer de recto. Efecto de la quimioterapia en el tiempo de espera.

INTRODUCTION: The introduction of sphincter preservation surgery in rectal cancer has led to an increase in the number of low resections protected with a loop ileostomy. This requires subsequent closure of the stoma, a surgical procedure which is not devoid of morbidity or mortality. The aims of the study were to analyse the clinical results of the passage reconstruction surgery and to find out the interval between both surgeries, as well as the role chemotherapy plays in this. PATIENTS AND METHOD: The prospective data of patients previously operated on for rectal cancer were used retrospectively with those whose ileostomy was closed between May 2004 and September 2008. Data associated to chemotherapy indication, interval between surgeries and complications were collected and analysed. RESULTS: A total of 54 consecutive patients with a mean age of 66 years were analysed. The mean interval between surgeries was 178 days, being significantly less in the patient group that did not receive chemotherapy (p=0.008). The post-operative stay was 6.3 days (SD=4.1). Mortality due to respiratory failure was 1.8% and the morbidity was 22.2%, with 7.4% requiring further surgery. CONCLUSIONS: The mortality and morbidity of ileostomy closures are not inconsiderable, although its advantages in the protection of the stoma justify its use. The ileostomy construction interval appears to be significantly affected by post-operative chemotherapy.

[Results of a study on populational colorectal cancer screening]. / Resultados de un estudio de cribado poblacional de neoplasia colorrectal.

INTRODUCTION: As colorectal cancer (CRC) screening based on occult blood detection has been shown to be effective in reducing mortality due to this disease, it is now important to decide on the best methods to obtain the maximum numbers of participants. The aim of the study was to analyse the results from a pilot CRC screening programme in a general population sample in Barcelona. A follow-up of false positive cases was made after five years. PATIENTS AND METHOD: A cross section of the population aged 50-74 years in one primary health care centre was studied. The screening test consisted of an immunological method for the detection of faecal occult blood which was sent to the homes of the target population. RESULTS: Participation was 46.6%, 11.7% of the tests were positive, and 79.3% agreed to have a colonoscopy. Eight adenocarcinomas and 32 patients with adenomas >0.4 cm were diagnosed. CONCLUSIONS: The results obtained on the initial participation and the follow-up at five years suggest the viability of a CCR screening programme in our country.

Resultados clínicos del cierre de ileostomías en asa en pacientes intervenidos de cáncer de recto. Efecto de la quimioterapia en el tiempo de espera / Clinical results of loop ileostomy closures in rectal cancer surgical patients. Effect of chemotherapy in the waiting period

Introducción: La implantación de la cirugía de preservación esfinteriana en el cáncer de recto ha hecho incrementar el número de resecciones bajas protegidas con una ileostomía en asa. Esto obliga a un posterior cierre del estoma mediante un acto quirúrgico no desprovisto de morbilidad ni mortalidad. Los objetivos del estudio fueron analizar los resultados clínicos de la cirugía de reconstrucción del tránsito y conocer el intervalo entre ambas cirugías, así como el papel que la quimioterapia determina en el mismo. Pacientes y método: Se utilizó retrospectivamente la base de datos prospectiva de los pacientes intervenidos previamente de cáncer de recto a los que se les cerró la ileostomía entre mayo de 2004 y septiembre de 2008. Se recogieron y analizaron los datos relativos a indicación de quimioterapia, intervalo entre cirugías, y complicaciones. Resultados: Se analizaron 54 pacientes consecutivos con edad media de 66 años. El intervalo medio entre cirugías fue de 178 días siendo significativamente menor en el grupo de pacientes que no recibió quimioterapia (p=0,008). La estancia postoperatoria fue de 6,3 días (DE=4,1). La mortalidad fue del 1,8% por causa respiratoria y la morbilidad fue del 22,2% con un porcentaje de reintervenciones del 7,4%. Conclusiones: La mortalidad y morbilidad del cierre de las ileostomía, no son despreciables, si bien sus ventajas en la protección del estoma justifican su uso. El intervalo de reconstrucción de la ileostomía, se ve afectado significativamente por la quimioterapia postoperatoria (AU)

Introduction: The introduction of sphincter preservation surgery in rectal cancer has led to an increase in the number of low resections protected with a loop ileostomy. This requires subsequent closure of the stoma, a surgical procedure which is not devoid of morbidity or mortality. The aims of the study were to analyse the clinical results of the passage reconstruction surgery and to find out the interval between both surgeries, as well as the role chemotherapy plays in this. Patients and method: The prospective data of patients previously operated on for rectal cancer were used retrospectively with those whose ileostomy was closed between May 2004 and September 2008. Data associated to chemotherapy indication, interval between surgeries and complications were collected and analysed. Results: A total of 54 consecutive patients with a mean age of 66 years were analysed. The mean interval between surgeries was 178 days, being significantly less in the patient group that did not receive chemotherapy (p=0.008). The post-operative stay was 6.3 days (SD=4.1). Mortality due to respiratory failure was 1.8% and the morbidity was 22.2%, with 7.4% requiring further surgery. Conclusions: The mortality and morbidity of ileostomy closures are not inconsiderable, although its advantages in the protection of the stoma justify its use. The ileostomy construction interval appears to be significantly affected by post-operative chemotherapy (AU)

Resultados de un estudio de cribado poblacional de neoplasia colorrectal / Results of a study on populational colorectal cancer screening

Introducción: el cribado poblacional de cáncer colorrectal (CCR) basado en la detección de sangre oculta en heces se ha demostrado efectivo en disminuir la mortalidad por esta enfermedad, si bien es importante encontrar los métodos adecuados para obtener una participación suficiente. El objetivo del estudio fue analizar los resultados clínicos de un programa piloto de cribado de CCR y las causas de rechazo. También se realizó el seguimiento de los casos falsos positivos a los 5 años. Pacientes y método: se diseñó un estudio de corte transversal en una población diana de 2.105 personas de 50 a 74 años atendidas en un centro de asistencia primaria. La prueba de cribado fue un método inmunológico, que se remitió al domicilio de la población diana. Resultados: la participación fue del 46,6%, el porcentaje de positividad de la prueba fue del 11,7% y la aceptación de la colonoscopia fue del 79,3%. Se diagnosticó en total a 32 pacientes con adenomas >0,4cm y a 8 con CCR. Conclusiones: los resultados obtenidos en nuestro estudio, tanto en participación como el seguimiento a los 5 años, permiten creer en la factibilidad de un programa de cribado poblacional de la neoplasia colorrectal en nuestro país (AU)

Introduction: As colorectal cancer (CRC) screening based on occult blood detection has been shown to be effective in reducing mortality due to this disease, it is now important to decide on the best methods to obtain the maximum numbers of participants. The aim of the study was to analyse the results from a pilot CRC screening programme in a general population sample in Barcelona. A follow-up of false positive cases was made after five years. Patients and method: A cross section of the population aged 50–74 years in one primary health care centre was studied. The screening test consisted of an immunological method for the detection of faecal occult blood which was sent to the homes of the target population. Results: Participation was 46.6%, 11.7% of the tests were positive, and 79.3% agreed to have a colonoscopy. Eight adenocarcinomas and 32 patients with adenomas >0.4cm were diagnosed. Conclusions: The results obtained on the initial participation and the follow-up at five years suggest the viability of a CCR screening programme in our country (AU)