Ackerman N B
Am J Surg. 1977 Jan;133(1):73-7. doi: 10.1016/0002-9610(77)90196-9.
The dynamics of arterial, venous, and lymphatic flow in the mesentery were studied in dogs, using an electromagnetic flowmeter for the blood and cannulation and gravimetric measurement for the lymph. Ligation of veins caused an increased venous outflow in adjacent veins and a marked increase in lymph flow. When marginal vessels were ligated, eliminating the major collateral flow, venous flow decreased, but elevated lymph flow persisted. Simultaneous ligation of arteries and veins resulted in increases of both arterial and venous flow in adjacent vessels. Lymph flow decreased unless excessive arterial collateral flow persisted. When collateral marginal vessel flow was occluded, adjacent venous and arterial blood flow decreased to control levels. With arterial ligation, collateral arterial blood flow increased slightly, but venous and lymph flow decreased sharply. When collateral marginal vessels were eliminated, adjacent arterial blood flow decreased to control levels and venous flow virtually stopped. As a result of these studies, the technic of early primary arterial ligation followed by marginal vessel ligation appears to be the most satisfactory procedure for decreasing venous and lymphatic outflow and hopefully avoiding dissemination of cancer cells during the operation. This technic is now being used as a modification of the "no touch" technic for cancer of the colon.
利用电磁流量计测量狗肠系膜动脉和静脉的血流，通过插管和重量法测量淋巴流量，研究了肠系膜动、静脉和淋巴的流动动力学。结扎静脉会使相邻静脉的静脉流出量增加，淋巴流量显著增加。当结扎边缘血管，消除主要的侧支血流时，静脉血流减少，但淋巴流量持续升高。同时结扎动脉和静脉会使相邻血管的动脉和静脉血流均增加。除非存在过多的动脉侧支血流，否则淋巴流量会减少。当侧支边缘血管血流被阻断时，相邻的静脉和动脉血流会降至对照水平。结扎动脉时，动脉侧支血流略有增加，但静脉和淋巴流量急剧减少。当消除侧支边缘血管时，相邻动脉血流降至对照水平，静脉血流几乎停止。这些研究结果表明，早期先行主要动脉结扎，随后结扎边缘血管的技术，似乎是减少静脉和淋巴流出量、有望避免术中癌细胞播散的最理想方法。这种技术目前正作为结肠癌“非接触”技术的一种改良方法被应用。
