Department of Surgery, Yonsei University College of Medicine, 250 Seongsanno(134 Sinchon-dong), Seodaemun-gu, Seoul 120-752, South Korea.
Int J Colorectal Dis. 2012 May;27(5):671-5. doi: 10.1007/s00384-011-1372-8. Epub 2011 Nov 29.
Colonic ischemia following colorectal surgery is an unusual and serious complication. As it has been reported that the incidence of colonic ischemia was higher after laparoscopic surgery, the aim of this report was to document the clinical features of postoperative colonic ischemia following colorectal surgery.
Among 1,201 surgeries for sigmoid colon and rectal cancer by a single surgeon from 2006 to 2010, 10 cases of postoperative colonic ischemia were retrospectively identified (0.83%). IMA high ligation was routinely made in all surgeries. The clinical findings and laboratory data of these 10 cases were evaluated.
Of the 10 patients, 9 were male and 1 was female. The mean age was 66.9 years old. The mean BMI was 23.3. Three patients (30%) had a cardiovascular disease other than hypertension. Eight patients (80%) underwent laparoscopic surgery and two patients (20%) underwent open surgery. Intraoperative bleeding occurred in five patients (50%, mean 435 ml). The average day for occurrence of postoperative colonic ischemia was on the 5th day (range 2nd-10th day). A consistent postoperative fever was found in eight patients (80%). Mortality due to postoperative colonic ischemia was 10%.
Postoperative colonic ischemia may be considered one of the more important complications of colorectal resection.
结直肠手术后的结肠缺血是一种不常见但严重的并发症。有报道称腹腔镜手术后结肠缺血的发生率更高，因此本报告旨在记录结直肠手术后结肠缺血的临床特征。
在 2006 年至 2010 年期间，由一位外科医生对 1201 例乙状结肠和直肠癌手术中，回顾性地确定了 10 例术后结肠缺血病例（0.83%）。所有手术均常规行肠系膜上动脉高位结扎术。评估了这 10 例患者的临床发现和实验室数据。
10 例患者中，9 例为男性，1 例为女性。平均年龄为 66.9 岁。平均 BMI 为 23.3。除高血压外，有 3 例患者（30%）患有心血管疾病。8 例（80%）患者接受腹腔镜手术，2 例（20%）患者接受开腹手术。有 5 例患者（50%）术中出血，平均出血量为 435ml。术后发生结肠缺血的平均天数为第 5 天（范围为第 2-10 天）。8 例患者（80%）出现一致的术后发热。由于术后结肠缺血导致的死亡率为 10%。
术后结肠缺血可能被认为是结直肠切除术后更重要的并发症之一。
