Shikata J, Shida T, Satoh S, Furuya K, Kamiyama A
Surg Gynecol Obstet. 1982 May;154(5):657-61.
Using dogs, we experimentally produced devascularized areas in the small intestine and colon and took quantitative measurements of the submucosal local blood flow using the hydrogen clearance method.. In the area slightly toward the ischemic side of the devascularized margin, local blood flow is less on the mesenteric side in both the ileum and the colon, and microcirculation is better maintained in the colon that in the ileum. When the anastomosis was performed in the area in which the local blood flow on the mesenteric side was 60 per cent of the control value in the ileum or 70 per cent in the colon, recovery of the control value was achieved by the seventh postoperative day. When anastomosis was performed in the area in which the local blood flow on the mesenteric side was 15 per cent of the control value in the ileum and 22 per cent of the control value in the colon, the flow on the mesenteric side did not recover to the level of the control value by the seventh postoperative day, and anastomotic leakage occurred in some dogs. All anastomotic leakage occurred on the mesenteric side. The local blood flow rate at the point at which the last signal was detected by Doppler ultrasound flowmeter after moving Doppler probe from the devascularized margin toward the ischemic side was 57 per cent of the control value in the ileum and 54 per cent of that in the colon. Such levels of blood flow are considered sufficient for successful healing of tissue after an anastomosis.
我们使用狗在小肠和结肠中实验性地制造了缺血区域，并使用氢清除法对黏膜下局部血流进行了定量测量。在缺血边缘略向缺血侧的区域，回肠和结肠系膜侧的局部血流较少，且结肠中的微循环比回肠中维持得更好。当在回肠系膜侧局部血流为对照值的60%或结肠为70%的区域进行吻合时，术后第七天达到对照值的恢复。当在回肠系膜侧局部血流为对照值的15%且结肠为22%的区域进行吻合时，术后第七天肠系膜侧血流未恢复到对照值水平，部分狗发生了吻合口漏。所有吻合口漏均发生在肠系膜侧。将多普勒探头从缺血边缘向缺血侧移动后，多普勒超声流量计检测到最后一个信号处的局部血流速率，在回肠中为对照值的57%，在结肠中为对照值的54%。这样的血流水平被认为足以使吻合术后组织成功愈合。
