[Anal intraepithelial neoplasia (NIA) and infection with human papillomavirus (HPV) in anoreceptive patients]. / La neoplasia intraepitelial anal y la infección por virus del papiloma humano en pacientes anorreceptivos.

BACKGROUND: An association between human papilloma virus (HPV) infection and progression to anal intraepithelial neoplasia (AIN) and epidermoid cancer has been established. OBJECTIVE: To know the prevalence of low and high grade AIN, as well as HPV infection in an anoreceptive patients group, infected or not, by human immunodeficiency virus (HIV). MATERIAL AND METHODS: All patients with anoreceptive sexual relations were considered in this study. Patients who accepted anal citology and high definition anoscopy and biopsies with a follow-up not minor of 3 months were included. RESULTS: Forty-four patients were included: 40 male (90.9%) with average age of 31 years. Anal cytology showed inflammatory alterations in 21 patients (28%), low grade intraepithelial lesion in 23 (52%); there were not patients with high grade epithelial lesion. According to the high definition anoscopy, there were low grade intraepithelial lesion in 42 patients (95%) and high grade in 2 (5%). Biopsy showed low grade intraepithelial in 26 patients (59%), high grade in 4 (9%) and inflammatory alterations in 14 (32%). The prevalence of AIN and HPV infection was 68% in both diseases. The HIV infection was associated with the presence of high grade AIN (p=0.002, OR 47.7) CONCLUSIONS: There is a high prevalence of AIN and HPV infection between patients with anoreceptive sexual relations. The HIV infection is a risk factor for the development of high grade AIN.

[Epidemiological characteristics of colorectal cancer in the General Hospital of Mexico. A 20 years analysis: 1988-2007]. / Comportamiento epidemiológico del cáncer de colon y recto en el Hospital General de México. Análisis de 20 años: 1988-2007.

INTRODUCTION: Distribution of colon and rectal tumors has been studied by many authors, which have considered that distal colon and rectum are more affected. However, its frequency and distribution have changed in recent years. OBJECTIVE: A descriptive analysis of colorectal cancer in the General Hospital of Mexico during the last 20 years (1988-2007). MATERIAL AND METHODS: This is a transversal comparative study between decades from the database of the Pathology Service of the General Hospital of Mexico, of cases of cancer diagnosed from January 1988 to December 2007. Variables included age, gender, anatomic site of the tumor,grade of differentiation, stadification and type of surgery. RESULTS: There were 222 cases from 1988 to 1997 and 400 cases from 1998 to 2007. 115 (52%) were female in the firs decade and 210 (53%) in the second. We found a prevalence of 71 cases (32%) for the proximal colon, 24 (11%) for the distal colon and 127 (57%) for the rectum in the first decade; in second decade there were 182 (45%) cases for the proximal colon, 50 (13%) for the distal colon and 168 (42%) for the rectum. CONCLUSIONS: The number of colorectal cancerduring the last decade almost doubled in our hospital (80%); we also found an increase in the number of proximal tumors and a decreasein the number of rectal tumors.

[Infrared photocoagulation in the treatment of hemorrhoids]. / La fotocoagulación por rayos infrarrojos en el tratamiento de la enfermedad hemorroidaria.

PURPOSE: The aim of this study was to determine the efficacy of infrared photocoagulation in the treatment of grades I and II of hemorrhoidal disease. MATERIAL AND METHODS: 60 patients with hemorrhoidal disease grades I and II were included, each one with transanal bleeding as the only symptom, without any other ano-rectal pathology. They were 30 male and 30 female patients, with 39.9 years as median age. Each had 1 to 4 photocoagulation sessions, according to the results obtained in each one. TECHNIC: Each application was 1.5 seconds duration, once every two weeks, in diamond or rainbow shape; 1 to 4 sessions were required. Follow up was 24 months. RESULTS: Good results were obtained in 66.6% since the second application, and in 93.4% at the end of the study; 4 (6.6%) patients were failures and had to be operated on. CONCLUSION: Treatment of hemorrhoidal disease grades I and II with infrared photocoagulation is an excellent alternative; it is painless, suitable as an outpatient procedure and its cost is low.

[Complex anal fistulas]. / Fístulas anales complejas.

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.