[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.

Phenylphenalenones from the Australian plant Haemodorum simplex.

Chemical investigation of the Australian plant Haemodorum simplex resulted in the isolation of three new phenylphenalenones, haemodorone (10), haemodorol (11), and haemodorose (12), together with the previously reported compounds 5, dilatrin (6), and xiphidone (8). The first complete 2D NMR characterization for all of the compounds isolated, including several chemical shift reassignments for dilatrin (6), is reported. In addition this is one of the few reports to discuss the isolation of new phenylphenalenones from an Australian medicinal plant. The crude extract of both the bulbaceous and aerial components of the plant exhibited varying degrees of antibacterial, antifungal, and antiviral activity, and only the bulbs displayed potent cytotoxic activity.

Naphthalene aglycones and glycosides from the Australian medicinal plant, Dianella callicarpa.

The crude extract of the roots from the Australian medicinal plant Dianella callicarpa (Liliaceae) displayed significant antimicrobial and antiviral activities. This prompted a chemical investigation, resulting in the isolation of the new naphthalene glycoside, dianellose (10), together with dianellin (1), dianellidin (2), dianellinone (3), stellalderol (9) and 5-hydroxydianellin (11). The structures for compounds 1, 9 and 10 were secured by detailed spectroscopic analyses, while compounds 2, 3 and 11 were identified on the basis of comparisons to literature data. Whilst the chemistry of the genus Dianella has previously been investigated, we report the first isolation of stellalderol (9) from this genus, together with the chemical and biological evaluation of the callicarpa species. Biological evaluation of the isolated compounds established that 2 showed antiviral and mild antimicrobial properties and that compounds 1, 9 and 10 displayed moderate antitumour activities.

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)