Ambrus R, Svendsen L B, Secher N H, Goetze J P, Rünitz K, Achiam M P
1 Department of Surgical Gastroenterology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
2 Department of Anesthesiology 2041, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Scand J Surg. 2017 Sep;106(3):241-248. doi: 10.1177/1457496916683098. Epub 2017 Mar 1.
During abdominal surgery, traction of the mesenterium provokes mesenteric traction syndrome, including hypotension, tachycardia, and flushing, along with an increase in plasma prostacyclin (PGI). We evaluated whether postoperative complications are related to mesenteric traction syndrome during esophagectomy.
Flushing, hemodynamic variables, and plasma 6-keto-PGF were recorded during the abdominal part of open ( n = 25) and robotically assisted ( n = 25) esophagectomy. Postoperative complications were also registered, according to the Clavien-Dindo classification.
Flushing appeared in 17 (open) and 5 (robotically assisted) surgical cases ( p = 0.001). Mean arterial pressure was stable during both types of surgeries, but infusion of vasopressors during the first hour of open surgery was related to development of widespread (Grade II) flushing ( p = 0.036). For patients who developed flushing, heart rate and plasma 6-keto-PGF also increased ( p = 0.001 and p < 0.001, respectively). Furthermore, severe postoperative complications were related to Grade II flushing ( p = 0.037).
Mesenteric traction syndrome manifests more frequently during open than robotically assisted esophagectomy, and postoperative complications appear to be associated with severe mesenteric traction syndrome.
在腹部手术期间，肠系膜的牵拉会引发肠系膜牵拉综合征，包括低血压、心动过速和潮红，同时血浆前列环素（PGI）增加。我们评估了在食管切除术期间术后并发症是否与肠系膜牵拉综合征相关。
在开放手术（n = 25）和机器人辅助手术（n = 25）的食管切除术腹部部分记录潮红、血流动力学变量和血浆6-酮-前列腺素F。还根据Clavien-Dindo分类记录术后并发症。
17例（开放手术）和5例（机器人辅助手术）手术病例出现潮红（p = 0.001）。两种手术类型中平均动脉压均稳定，但开放手术第一小时使用血管升压药与广泛（II级）潮红的发生有关（p = 0.036）。对于出现潮红的患者，心率和血浆6-酮-前列腺素F也增加（分别为p = 0.001和p < 0.001）。此外，严重术后并发症与II级潮红有关（p = 0.037）。
肠系膜牵拉综合征在开放食管切除术中比机器人辅助食管切除术中更频繁出现，并且术后并发症似乎与严重的肠系膜牵拉综合征有关。
Zotero 插件