BackgroundThe most common injury to indicate definitive stoma is rectal cancer. Despite advances in surgical treatment, the abdominoperineal resection is still the most effective operation in radical treatment of malignancies of the distal rectum invading the sphincter and anal canal. Even with all the effort that surgeons have to preserve anal sphincters, abdominoperineal amputation is still indicated, and a definitive abdominal colostomy is necessary. This surgery requires patients to live with a definitive abdominal colostomy, which is a condition that modify body image, is not without morbidity and has great impact on the quality of life.AimTo evaluate the technique of abdominoperineal amputation with perineal colostomy with irrigation as an alternative to permanent abdominal colostomy.MethodRetrospective analysis of medical records of 55 patients underwent abdominoperineal resection of the rectum with perineal colostomy in the period 1989-2010.ResultsThe mean age was 58 years, 40 % men and 60 % women. In 94.5% of patients the indication for surgery was for cancer of the rectum. In some patients were made three valves, other two valves and in the remaining no valve at all. Complications were: mucosal prolapse, necrosis of the lowered segment and stenosis.ConclusionThe abdominoperineal amputation with perineal colostomy is a good therapeutic option in the armamentarium of the surgical treatment of rectal cancer.
PURPOSE:To investigate immunohistochemical aspects of the myenteric plexus of valves constructed in the colon of rats to verify whether any denervation occurs both at the operative site and in those areas adjacent to the third valve. METHODS:Thirty six male Wistar rats divided into the following three groups were used: Control Group (CG); Amputated Group (AG); Amputated Group with Valves (AGWV). In AG was held in the rectum amputation and the colon was sutured to the skin elaborating the perineal colostomy. In AGWV was held in the rectum amputation. A laparotomy was performed for the manufacture of valves (seromyotomy) in the colon. After this step, the colon was sutured to the skin elaborating the perineal colostomy. The density of the neural elements in the muscular wall as marked specifically using Protein Gene Product (PGP) 9.5 and utilising the proper tools of the KS300 software for measuring the area. From these measurements, a relation and three proportions were drawn and analysed according to the mean of the averages obtained from the measured images. RESULTS:Immunoexpression of PGP 9.5 demonstrated a total absence of neural elements and myenteric plexus at the valve site. The density of the neural elements in the circular muscular layer at sites adjacent to the 3 rd valve was lesser, however, was not significantly different. CONCLUSION:The immunohistochemical study of valves constructed in the colon of rats submitted to abdominoperineal amputation and perineal colostomy revealed denervation at the seromyotomy site.Key words: Amputation. Colostomy. Myenteric Plexus. Colorectal Surgery. Immunohistochemistry. Rats. Morphology and immunohistochemistry of the myenteric plexus of valves constructed in the colon of rats submitted to abdominoperineal amputation and perineal colostomy
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