V-Y advancement flaps for extensive perianal defect repair

OBJECTIVES

Some perianal pathologies require aggressive surgery that will need techniques to allow to re-establish the integrity of the perianal region. The purpose is to analyze short and long term results after perineal reconstruction with V-Y flaps.

METHODS

A retrospective review of prospectively collected database was conducted at Virgen de la Arrixaca's Hospital in Murcia (España) between January 2000 and December 2013. The study includes all patients who underwent a perineal reconstruction with V-Y flaps. Demographic and surgical data and short-/long- term morbidity was recorded.

RESULTS

10 patients were included, 6 males and 4 females. The average age was 58,1±17,4 years. Surgical indication included both malignant and benign pathologies. Operating time was 143,5±41,3min. R0 resection was performed in all cases although histopathological analysis showed involvement of the deeper margin in 3 cases. Length of hospital stay was 7,8±7,6 days. Regarding complications: 6 patients had partial dehiscence of the flap. None of the patients lost the flap completely. The most frequent late complication was anal stenosis (n=4). Follow up showed total continence in 7 patients. Two patients had variable fecal and/or flatus incontinence. A colostomy was made in one case due to severe incontinence.

CONCLUSIONS

V-Y flaps are an effective and feasible technique to cover large perianal defects after aggressive surgeries. However, this technique is not free of postoperative morbidity.

Intracorporeal ileocolic anastomosis in patients with laparoscopic right hemicolectomy

BACKGROUND

Since the introduction of laparoscopic colorectal surgery, there has been a controversy between creating an intracorporeal or extracorporeal ileocolic anastomosis in right hemicolectomy. The purpose is to report our experience in intracorporeal anastomosis following right hemicolectomy in both malignant and benign pathologies.

STUDY DESIGN

A retrospective review of a prospectively collected database was conducted at Virgen de la Arrixaca Clinical University Hospital (Murcia) between January 2000 and April 2014. The study includes all surgery patients who received a laparoscopic right hemicolectomy with an intracorporeal ileocolic anastomosis. The criteria for exclusion were conversion to open surgery during the procedure due to technical difficulties during dissect. Tumours considered T4 were not excluded, nor were stage IV patients or those with a history of previous abdominal surgery.

RESULTS

There were 173 patients (63 females) aged 67 (range 14-91) years, with body mass index of 27 (17-52) kg/m(2) and ASA 1:2:3:4 of 12:78:68:15; 41% had previous abdominal surgery and 70% had a pre-existing comorbidity. Operating time was 142 (60-270) min. Specimen extraction site incision length was 8.1 (6-11.1) cm. Conversion rate was 9.2%, and there were 39 complications (22.54%) and 9 reoperations (5.2%). Readmission rate was 5.2%. Length of stay was 5.7 (1-35) days.

CONCLUSION

The intracorporeal procedure is a safe and feasible alternative for creating an ileocolic anastomosis. It involves a similar rate of complications and may prevent some of the drawbacks presented by extracorporeal anastomosis.

Aportació al coneixement de l’herbari Trèmols de l’Institut Botànic de Barcelona

El herbario BC-Trèmols fue creado durante la segunda mitad del siglo XIX por el químico y botánico catalán Frederic Trèmols i Borrell. Entre 1930 y 1960, el técnico Antoni Marcos llevó a cabo una profunda revisión. La colección actual consta aproximadamente de unos 9000 pliegos; está formada por 58 volúmenes reordenados por Marcos, más otros dos con la estructura original, cuatro cajas de Hieracium y 85 cajas de material adicional. Hasta la fecha se han informatizado 22 de los volúmenes y las cuatro cajas de Hieracium (3695 especímenes), se ha llevado a cabo un inventario a nivel de género de todos los volúmenes y se ha informatizado el catálogo original del herbario y el fichero taxonómico existente. También se ha elaborado un inventario preliminar del contenido de las cajas adicionales. El análisis de los 3695 especímenes revela que el herbario está formado mayoritariamente (67,1%) por pliegos de intercambio obtenidos principalmente a través de la Société Helvétique pour l’Échange des Plantes y la Societat Botànica Barcelonesa. Entre los materiales estudiados se han localizado dos pliegos que consideramos interesantes desde un punto de vista taxonómico y/o nomenclatural (isótipos de Silene holzmanii Heldr. ex Boiss. y de Arenaria minutiflora Loscos). El interés principal del herbario radica, pues, en la gran diversidad de procedencias geográficas de las plantas, que hacen de esta colección uno de los primeros «herbarios europeos» de Cataluña. [ca] L’herbari BC-Trèmols fou creat durant la segona meitat del segle XIX pel químic i botànic català Frederic Trèmols i Borrell. Entre 1930 i 1960, el tècnic Antoni Marcos va fer-ne una profunda revisió. La col·lecció actual consta aproximadament d’uns 9000 plecs; està formada per 58 volums reordenats per Marcos, dos volums amb l’estructura original, quatre capses de Hieracium i 85 capses de material addicional. Fins ara s’han informatitzat 22 dels volums i les quatre capses de Hieracium (3695 espècimens), s’ha realitzat un inventari a nivell de gènere de tots els volums i s’ha informatitzat el catàleg original de l’herbari i el fitxer taxonòmic existent. També s’ha elaborat un inventari preliminar del contingut de les capses addicionals. L’anàlisi dels 3695 espècimens fa evident que l’herbari està format majoritàriament (67,1%) per plecs d’intercanvi obtinguts sobretot mitjançant la Société Helvétique pour l’Échange des i la Societat Botànica Barcelonesa. Entre els materials estudiats s’han trobat dos plecs que considerem interessants des d’un punt de vista taxonòmic i/o nomenclatural (isotipus de Silene holzmanii Heldr. ex Boiss. i d’Arenaria minutiflora Loscos). L’interès principal de l’herbari, doncs, rau en la gran diversitat de procedències geogràfiques de les plantes, que fan d’aquesta col·lecció un dels primers «herbaris europeus» de Catalunya.

[Seasonal changes in the female reproductive apparatus of Lepus europaeus (P) in a population from the rural area of Rio Cuarto (Cordoba-Argentina)]

In this paper, the reproductive cycle of the European hare, Lepus europaeus, was studied during a complete annual period in females of a population from the southern region of the province of Cordoba. The animals were captured monthly. Age, corporal and ovarian weights were determined, and the ovaries were fixed in Bouin and processed by current histological techniques. During the period from July to February, the mean corporal weight was 3.70 kg +/- 0.15. The ovaries showed follicles in different developmental stages, corpora lutea and interstitial gland. Embryos were frequently found in the uterus. From March to June, on the other hand, mean corporal weigth was 3.16 kg +/- 0.11. The ovaries presented developing follicles, interstitial gland and corpora albicans, and no corpora lutea were found. From these results, it can be seen that the reproductive cycle is composed of two well-defined periods: I) Reproductive period, extending from July to February, and II) Non-reproductive period, form March to June. The results are compared with those obtained by other authors on other hare populations, specially on populations from the southern region of Argentina (Bariloche), taking into account regional environmental characteristics.

A specific fluorogenic reaction for tryptophan residues using isatin in organic solvents

The development of new fluorogenic reactions for specific chemical groups is of increasing interest in cytochemistry. We describe the application of the nonfluorescent compound isatin on methanol-fixed blood smears. When treated with 0.1% isatin in absolute ethanol or acetone for 30 min and observed under violet-blue exciting light, eosinophil leucocyte granules show a bright green fluorescence. This fluorogenic reaction is abolished after blocking of tryptophan residues by performic acid oxidation. Spectrofluorometric studies with amino acids in vitro reveal that isatin forms a unique and specific fluorescent product with tryptophan.