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Revista do Colégio Brasileiro de Cirurgiões

Print version ISSN 0100-6991On-line version ISSN 1809-4546


SILVA, José Hyppolito da; SODRE, Luciana de Azevedo; MATHEUS, Cláudio de Oliveira  and  FORMIGA, Galdino J. S.. Surgical treatment of chagasic megacolon: abdominal rectocolectomy with mechanical colo-rectal end- to-side anastomosis. Rev. Col. Bras. Cir. [online]. 1999, vol.26, n.5, pp.285-289. ISSN 1809-4546.

Thirty five patients with chagasic megacolon were operated on by the technique of recto-colectomy with colo-rectal mechanical end-to-side anastomosis, anterior or posterior during the period of 1993 to 1997. Twenty (57.14%) patients were female and 15 (42.85%) male. The age ranged from 27 to 76 years, with a mean of 51years. The operation consisted of resection of the dilated colon, closure of the rectal stump at the level of the peritoneal reflexion, dissection of the rectrorectal space down to the level of the levator ani and posterior end to side colo-rectal mechanical anastomosis. Four (11.42%) patients had the anastomosis made anteriorly. Three (8.57%) patients had a positive test of the anastomosis integrity and demanded suture in two (5.71%) and suture and ostomy in one (2.85%). There were seven postoperative early complications, four (11.42%) considered important and four late complications. There was one (2.85%) death due to clinical complication. Patients that underwent colostomy were reoperated in order to close it with no problems. The totality of patients has normal bowel function. There were no complaints of sexual, urinary disturbances or fecal incontinence. The anastomosis was examined in all patients. There was no case of fecaloma in the rectal stump. Although the initial results are good, a long follow up is necessary to evaluate the possibility of recurrence.

Keywords : Chagasic megacolon; Recto-colectomy; Mechanical anastomosis.

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