[Interposition of the small intestine between the colon and the rectum as a way of achieving a pelvic anastomosis without pressure].

PURPOSE 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. CONCLUSION 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.