[Interposition of the small intestine between the colon and the rectum as a way of achieving a pelvic anastomosis without pressure].
OBJECTIVE
There are some circumstances in which the descending colon does not reach the pelvis to complete a colorectal anastomosis without tension. Re-establishing intestinal continuity by interposing small bowel as a bridge between the colon and the rectum could be an acceptable surgical alternative.


METHODS
We describe the interposition of one or two segments of small bowel as a way of restoring continuity of the colon and rectum in three patients in whom it was not possible to perform a colorectal anastomosis without tension due to ischaemic colon, synchronous cancer or difficulty in accessing the supramesocolic space, respectively.


RESULTS
Intestinal continuity was re-established in all patients with no significant morbidity and good intestinal function.


CONCLUSIONS
The interposition of small bowel segments between the colon and the rectum should be considered a valid surgical option when it is not possible to achieve a well-perfused, tension-free pelvic colorectal anastomosis.
Sección Cirugía Colorrectal, Servicio Cirugía General y Digestiva, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España. Electronic address: josemaria.enriqueznavascues@osakidetza.net.
Jose M
JM
Enríquez-Navascues
Araceli
A
Rodríguez
Carlos
C
Placer
Yolanda
Y
Saralegui
Alberto
A
Carrillo
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods; D006801:Humans; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012007:Rectum / Q000601:surgery*
Anastomosis colorrectal; Anastomosis colorrectal difícil; Anastomosis pélvica; Colorectal anastomosis; Difficult colorectal anastomosis; Interposición intestino delgado; Pelvic anastomosis; Small bowel interposition