Sakakibara Y, Jikuya T, Saito E M, Mitsui T, Ijima H
Department of Surgery, University of Tsukuba, Japan.
Thorac Cardiovasc Surg. 1997 Feb;45(1):32-4. doi: 10.1055/s-2007-1013680.
Acute ischemic colitis is noted as a rare but lethal complication of abdominal aortic aneurysm (AAA) surgery. Because of its high mortality a reliable method of monitoring colonic blood perfusion to predict the possible occurrence of ischemic colitis is highly desirable for AAA surgery. We have tested the use of a laser Doppler flowmeter placed on the surface of the sigmoid colon for intraoperative monitoring in 31 patients with AAA. Although most of the patients showed the same flow levels after aorto-iliac or aorto-femoral grafting (at least unilaterally the internal iliac artery was perfused), in 6 cases poor colonic perfusion (below 50% of the basal flow) was observed and inferior mesentric arterial reconstruction was performed. In these 6 patients, sigmoid colonic blood perfusion returned from 37% to 82% of preoperative value after the reconstructions. No ischemic colitis was noted in this series of patients. We suggest that monitoring of serosal blood flow in the sigmoid colon using a laser Doppler flowmeter is useful for the management of patients during abdominal aortic aneurysm surgery.
急性缺血性结肠炎被认为是腹主动脉瘤（AAA）手术罕见但致命的并发症。由于其高死亡率，对于AAA手术而言，一种可靠的监测结肠血流灌注以预测缺血性结肠炎可能发生的方法非常必要。我们对31例AAA患者使用置于乙状结肠表面的激光多普勒血流仪进行术中监测。尽管大多数患者在进行主-髂或主-股动脉移植术后（至少单侧髂内动脉有灌注）血流水平相同，但有6例患者观察到结肠灌注不良（低于基础血流的50%），并进行了肠系膜下动脉重建。在这6例患者中，重建术后乙状结肠血流灌注从术前值的37%恢复到82%。该系列患者中未发现缺血性结肠炎。我们认为，使用激光多普勒血流仪监测乙状结肠浆膜血流对腹主动脉瘤手术患者的管理是有用的。
