The feasibility of performing colostomy closures using local anesthesia was evaluated. The subjects comprised 14 patients: 2 with colostomies involving a mucous fistula and 12 with loop colostomies. Patients who had colostomies with mucous fistulas separated by 10cm or more were excluded from this study. All patients were graded as ASA 1 (according to the American Society of Anesthesiologists). The bowel was evaluated by colonoscopy in 6 patients and by barium enema in 8 patients. Bowel preparation was performed with Colayte and all patients were given prophylactic antibiotics. Closure of the colostomy was extraperitoneal and the time taken to perform the operation ranged from 40 to 120min. Tolerance was regarded as excellent in 9 patients, good in 3, and average in 2. There were 3 anastomotic leaks that resolved without further surgical treatment, 2 wound infections, and 1 bowel obstruction that was successfully treated with medication. Patients were discharged 2-22 days postoperatively, after a mean period of 9 days. Local anesthesia offers a safe and effective alternative to general or regional anesthesia for surgical closure of colostomies.

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Introducción: El mucocele apendicular es la dilatación quística del apéndice con acumulación de material mucinoso. Su forma de presentación más frecuente es dolor en fosa ilíaca derecha, sin embargo, la mitad de los casos son asintomáticos. En el presente trabajo se presenta caso de un paciente con diagnóstico incidental de mucocele apendicular, al cual se le realizó apendicectomía laparoscópica como tratamiento definitivo. Caso clínico: Paciente masculino de 44 años sin antecedentes patológicos conocidos, quien se realiza ultrasonido abdominal que informa tumor quístico en fosa ilíaca derecha. Se decide resolución quirúrgica laparoscópica. Informe histológico: mucocele apendicular sin evidencia de malignidad y recuperación satisfactoria del paciente. Conclusión: La neoplasia mucinosa del apéndice es una patología poco frecuente, puede presentarse con una variedad de manifestaciones clínicas hasta un hallazgo incidental. El tratamiento es fundamentalmente quirúrgico y el abordaje laparoscópico es de elección en pacientes sin evidencia de ruptura y diseminación de la enfermedad.