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Aim: Venous microanastomoses are more difficult to carry out in comparison with the arterial ones, because of the characteristics of the vascular wall. The suture with loose stitches is the usual surgical technique, but it has 2 disadvantages: a long time of execution and the presence of foreign material in the anastomosis. To avoid these complications, we an extraluminal silicone cuff has been used., Methods: We performed 70 microanastomoses on the internal jugular vein of Sprague-Dawley rats with these 2 techniques, estimating the immediate and late permeability and postoperative complications. Moreover, a histological study of all the anastomoses was carried out on the 15th day and after 1 mo from the intervention., Results: The mean time requested to perform the microanastomosis is significatively shorter when using the extraluminal cuff. The late permeability with standard suture is 97% and 77% with the cuff. The number of complications with standard suture is significatively lower than with cuff, where rates of 20% of dehiscence and 14% of trombosis were observed. The histological study showed a poor alteration of the vascular wall, with important subendothelial hypertrophy on cuff microanastomosis and a great permanent histopatologic alteration if the standard technique had been used., Conclusions: The suture with loose stiches is a very good technique to use for this type of microanastomosis, even if the extraluminal cuff can be used in microanastomosis of a free graft or when it is necessary to perform more than 1 microanastomosis.

Background: The goal of this study is to compare the usual surgical technique with the use of fibrin glue, which is faster to perform and has few histological alterations in the anastomosis., Methods: We performed 70 microanastomoses on the internal jugular vein of the Sprague-Dawley rats, and we estimated: immediate and late permeability and postoperative complication. Besides, we made a histological study of all the anastomoses on the 15th day and after one month of the intervention., Results: The middletime request to practise the microanastomosis is significantly shorter when using the fibrin glue. The late permeability rate with standard suture is 97 and 77% with fibrin glue. The number of complications is similar, even if we found a 14.7% rate of aneurysms in the anastomosis with fibrin glue. The histological study showed few alterations to the vascular wall in the fibrin seal group and a great permanent histopathological alteration in the standard technique., Conclusions: The use of fibrin glue is a very good technique for this kind of microanastomosis. It is fast to perform, has few histological alterations and a similar permeability rate although careful approximation of the vascular edges is necessary to get a good anastomosis.

Verneuil's disease or perianal hidradenitis suppurativa is a chronic suppurative disease with a tendency to fistulization and sclerosis, developing on the subcutaneous tissue, on apocrine glands. The perianal location is the most frequent, and the elective therapy in such case is surgery. A case of perianal Verneuil's disease of great size, invalidating for the patient, in which medical therapy failed, making necessary an aggressive surgical treatment is reported. The therapeutical possibilities of this disease and its possible complications, are discussed.

Aim: To assess whether there is a correlation between the onset of postoperative sepsis and the 5-years survival rate in patients undergoing surgery for rectal cancer., Experimental Design: A retrospective study of all patients, undergoing rectal cancer surgery during the period January 1981-December 1987., Place: General Surgery Unit, Hospital Arnau de Vilanova., Patients: All patients operated with Duke's stage B and C colorectal neoplasms, excluding cases with postoperative complications not directly correlated to surgery: pneumonia, thromboblebitis, urinary infection or fever of unknown origin., Findings: Postsurgical complications distinguished as minor (wall abscess) or major (anastomotic dehiscence, peritoneal abscess). 5-year survival rate., Results: The actuarial 5-year survival rate of patients with major septic complications was significantly lower (p < 0.05) than that in noncomplicated cases. No difference was observed in the survival of patients with and without minor septic complications., Conclusion: Major septic complications secondary to colorectal surgery are still a threat in spite of improved techniques and antibiotic prophylaxis, and negatively influence the long-term survival rate.