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Media report claims Castro chose risky treatment option

Cuban President Fidel Castro directed his surgeons to pursue the riskier option of surgery rather than performing a colostomy that would have forced him to be dependent on a bag for bodily functions, according to new details published in a Spanish newspaper.

The operation failed when a suture burst, leaving Castro gravely ill, El Pais newspaper reported on Wednesday. Cuban officials have denied the account.

After removing an inflamed piece of Castro's large intestine in an operation last year, the doctors connected the remainder directly to his rectum, rather than attaching a colostomy bag, El Pais said, quoting two medical sources at Madrid's Gregorio Maranon hospital. The operation failed when the suture burst.

"The Cuban dictator and his advisers are the ones who decided on the surgical technique that has led to the complications," the paper said.

Experts say that it's possible Castro and his surgeons went for the riskier procedure to spare him the indignity of being temporarily attached to a colostomy bag for waste removal. In standard colostomies, patients are only dependent on such bags for approximately six weeks.

Attempting to reattach the colon to the rectum is an inherently trickier surgical procedure, since waste from the colon can leak out into the abdomen, causing infection.

"It sounds like they took a gamble and they lost," said Peter Shamanian, an associate professor of surgery at New York University School of Medicine, referring to Castro's surgeons.

Though Shamanian said it is difficult to speculate on Castro's condition, he said colostomies are a standard procedure that do not usually result in serious complications. Most physicians, he said, would probably opt for a colostomy in the first instance.

"It's always a bad idea to let the patient make the choice," he said.

While the newspaper article did not name the sources, one of the journalists who wrote it said that both were doctors at the hospital. The journalist, Oriol Guell, said none of the information in the articles published on Tuesday and Wednesday came from surgeon Jose Luis Garcia Sabrido, who works at the hospital and flew to Cuba last month to treat the 80-year-old Castro.

Garcia Sabrido, the Madrid hospital's chief surgeon, said the El Pais account of Castro's condition as being grave was wrong, according to an interview posted on CNN's Web site.

"The only truthful parts of the newspaper's reports are the name of the patient, that he has been operated on, and that he has had complications. The rest is rumors," Sabrido was quoted as saying.

He declined to give details on Castro's condition, according to the interview.

A Cuban diplomat in Madrid said on Tuesday that the newspaper's report on Castro's health was "an invented story."
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