Hemicolectomía derecha: resultados de la cirugía no programada y electiva / Right hemicolectomy: results of non programmed and elective surgery

Se revisa los resultados obtenidos en 116 pacientes sometidos a hemicolectomía derecha y anastomosis primaria. Un 30% de ellos fueron intervenidos en forma no programada (grupo A), sin mediar preparación de colon preoperatoria y un 70% en forma electiva (grupo B). En el grupo A la indicación más frecuente fue la obstrucción intestinal. En un 90% de los pacientes del grupo B la indicación fue el cáncer de colon. Complicaciones postoperatorias se observó en un 33% y 11% de los grupos A y B respectivamente. El mayor número de complicaciones en el grupo A está dado por infecciones de herida operatoria. Dos pacientes fallecieron, ambos del grupo A, sin mediar complicaciones derivadas de la técnica quirúrgica. Se concluye que la hemicolectomía derecha y anastomosis primaria constituye una alternativa quirúrgica segura para ambos grupos de pacientes

Enteritis actínica: resultados del tratamiento quirúrgico / Radiation enteropathy: results of surgical therapy

We reviewed the results of surgical therapy for radiation enteropathy in 18 consecutive patients. Fifteen (83%) were females and the age ranged from 31 to 81 years old. The indication for radiotherapy was cancer of the cervix in 10 patients (56). The mjean radiation dose was 5190 rads (range 4000 to 7000). Of 23 radiation lesions, 12 (52%) were located in the ileon, 10 in the rectum and 1 in the sigmoid. Fibrosis and stenosis was the most frequent lesion (70%) followed by fistulae (22%) and proctitis in 2 patients. Ressection or derivation was the surgical treatment employed in 22 of the 23 lesions. For lesions of the ileon, we performed ressection and anastomosis in 7 patients and derivation in 5. For rectal lesions we performed ressection, endoanal descent and colo-anal anastomosis in 7 patients anterior ressection in 2 and colostomy in 1. complications were observed in 5 patients (28%) and 1 patient died (5%). After a mean follow up of 56 months, 5 patients have died from recurrence of the original neoplastic lesions. We feel that surgical treatment allows improvement in quality of life of patients with radiation entreropathy