Suture line recurrence is an important cause of failure after potentially curative resection for colonic carcinoma. Our aim was to determine whether suture technique affected the incidence of perianastomotic tumours in experimentally induced colonic cancer. Sprague-Dawley rats were randomized into three groups. A 1 cm longitudinal colotomy was repaired with four interrupted 6/0 polypropylene monofilament sutures, using either a transmural technique (n = 18) or a seromuscular technique (n = 18). Control animals (n = 18) had a sham laparotomy. All animals received nine, weekly, subcutaneous injections of azoxymethane (total dose 90 mg/kg) starting 6 weeks after laparotomy. Surviving animals were killed 32 weeks after laparotomy. Five animals from each group were given intraperitoneal bromodeoxyuridine (100 mg/kg) 1 h before being killed. At death, perianastomotic tumours occurred more frequently in animals with transmural sutures than in either controls or those with seromuscular sutures. This difference was associated with a greater mucosal bromodeoxyuridine crypt cell labelling index in the transmural suture group. We conclude that a transmural anastomotic suture technique promotes the development of experimental perianastomotic colonic tumours.

and corneal transplants, and in preservation of the transient amplifying cells. 9 The poor long-term outcome following simultaneous limbal transplantation and penetrating keratoplasty has prompted the recommendation of a staged procedure with a 1-year gap. 8 Though a stable ocular surface and good vision have been attained following these surgeries, the inherent pathology remains. Photoprotective measures have been advocated and the patient has been cautioned about the possible development of ocular or cutaneous manifestations of XP described earlier. Indefinite immunosuppression remains necessary to ward off limbal allograft rejection. 10 The patient is on low doses of cyclosporine ensuring serum trough levels of 50 ng/ml, regular assessment of renal and hepatic parameters, and on close follow-up in conjunction with an internist.In summary, limbal stem cell deficiency may be one of the ocular manifestations of xeroderma pigmentosum, necessitating a high degree of suspicion and early surgical intervention to prevent visual disability. References

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