Experimental and clinical study of the colonic ischemic state in the distal colon after left-sided hemicolectomy.

• Maeda K

  Department of Surgery, School of Medicine, Keio University

Bibliographic Information

Other Title

• 左側結腸切除時におけるこう門側腸管の血行状態に関する実験的・臨床的研究

Abstract

It is often technically difficult to anastomose the colon near the peritoneal reflection with apprehension regarding severe ischemia in the distal colon after extended left-sided hemicolectomy. This study was designed to investigate how far proximally from the peritoneal reflection the middle and inferior rectal arteries can nourish the distal colon after the high ligation of the infererior mesenteric artery on extended left-sided hemicolectomy. <BR>Viability of the ischemic colon and the critical level of ischemia for safe colonic anastomosis were studied experimentally with both fluorescence pattern and tissue partial oxygen tension (PtO₂) five minutes after producing ischemia. The ischemic colon with no fluorescence pattern (PtO₂ 16 mmHg) was not viable. Ischemic colons showing normal (PtO₂ 52 mmHg), fine patchy (PtO₂ 41 mmHg), or coarse patchy pattern (PtO₂ 27 mmHg) showed satisfactory anastomosic healing. <BR>Observations in nine patients undergoing extended left-sided hemicolectomy revealed sufficient blood flow for anastomosis in the distal colon up to 20 cm from the peritoneal reflection and even higher in some case.

Journal

• Nippon Daicho Komonbyo Gakkai Zasshi

  Nippon Daicho Komonbyo Gakkai Zasshi 43 (4), 542-553, 1990

  The Japan Society of Coloproctology

Keywords

• 肛門側残存腸管の血行状態
• 左側結腸切除
• フローレッセン螢光法
• 組織酸素分圧
• 虚血大腸

Details

• CRID: 1390001204854773376
• NII Article ID: 130000783297
• DOI: 10.3862/jcoloproctology.43.542
• ISSN: 18829619
• ISSN: 00471801
• Web Site: http://www.jstage.jst.go.jp/article/jcoloproctology1967/43/4/43_4_542/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/1992070055
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed