ABSTRACT
The results of the surgical treatment of the acute mesenteric ischemia in 2 groups of patients were comparatively analyzed. The control group (n=52) experienced the traditional way and criteria of detecting the volume of intestinal resection (color and peristaltic activity, arterial pulsation). For the main group (n=57) the intraoperative estimation of the intestinal viability was performed with the help of laser Doppler flowmetry. As a result, the postoperative intestinal gangrene rate was 9.1% among patients of the main group, whereas the complication was registered among 48.6% of the control group. The main group of patients demonstrated the overall lower rate of postoperative complications in comparison with the control group: 67.6 and 40.9% (p=0.01), respectively. The same picture was for the lethality rate: 76.9 and 52.6% (p=0.03), respectively.
Subject(s)
Digestive System Surgical Procedures , Gangrene , Intestine, Small , Ischemia , Laser-Doppler Flowmetry/methods , Postoperative Complications/prevention & control , Vascular Diseases , Aged , Digestive System Surgical Procedures/adverse effects , Digestive System Surgical Procedures/methods , Digestive System Surgical Procedures/mortality , Female , Gangrene/etiology , Gangrene/prevention & control , Humans , Intestine, Small/pathology , Intestine, Small/surgery , Intraoperative Care/instrumentation , Intraoperative Care/methods , Ischemia/diagnosis , Ischemia/physiopathology , Ischemia/surgery , Male , Mesenteric Ischemia , Retrospective Studies , Treatment Outcome , Vascular Diseases/diagnosis , Vascular Diseases/physiopathology , Vascular Diseases/surgeryABSTRACT
The study represents the retrospective analysis of major intestinal resections (the length of the left in olace bowel less then 200 sm) and non-major resections in 52 patients operated on the acute mesenterial thrombosis. Major bowel resection was performed in 30 patients (57.7%). 66.7% of those patients (20 of 30) died soon after the operation. Whereas lethality rate among patients with non-major resections was 54.5% (12 of 22). All 10 survived patients demonstrated the short-bowel syndrome during the follow-up period (the median follow-up time was 25 months).
Subject(s)
Intestines/surgery , Mesenteric Arteries/pathology , Short Bowel Syndrome/surgery , Thrombosis/surgery , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Postoperative Complications , Retrospective Studies , Short Bowel Syndrome/blood , Short Bowel Syndrome/pathology , Thrombosis/pathologyABSTRACT
Quantitative and functional parameters of regional intestinal blood circulation were intraoperatively investigated with the use of laser Doppler flowmetry. The first group consisted of patients with necrotized parts of the intestine, while the second (control) group consisted of flowmetry data from intact intestine. Such indexes, as basal circulation, variation coefficient, blood oxygen perfusion saturation index, maximal perfusion amplitude of endothelial, neurogenic and myogenic oscillations in the intestinal volume, were showed to be valuable for the intestinal viability assessment. Thus, the method of the intraoperative laser Doppler flowmetry can be useful for determining the volume of intestinal resection.
