The article presents the scale developed by authors of prognostic assessment of ischemic colitis evolution in patients after planned resection of infrarenal aortic aneurism. A retrospective analysis of medical histories of 201 operated patients and statistical data manipulation were made at the period from 1985 to 2016. It was stated, that score less than 2 points represents patients of high risk group of ischemic colitis development. The scale of sensitivity consisted of 80% and scale of specificity - 63,4%. The score of developed scale depended of passability and blood flow condition in the inferior mesenteric, the right and left internal iliac arteries being evaluated during surgery. The aim of surgeons is to increase the number of points in the scale using revascularization of the inferior mesenteric and at least one of internal iliac artery in patients of the high risk group of ischemic colitis development.
Cardiovascular disease (CVD) is the leading cause of death worldwide. The main contribution to the structure of mortality from CVD is made by atherosclerosis. Indications for surgical treatment of patients with diseases caused by atherosclerotic lesions of the arteries are set taking into account the degree of their stenosis. Angiography has been considered the gold standard for screening patients with CVD for many years. Numerous studies carried out over the past several decades have revealed the weak side of this method in assessing the significance of borderline stenosis. Therefore, to analyze such changes, functional tests were introduced to clarify the indications for surgical intervention. Currently, criteria for the significance of stenosis of the iliac, renal and coronary arteries have been determined. The significance of stenosis of the arteries supplying the brain and intestines is still a matter of debate and requires further study.
The retrospective analysis of the data of 197 patients who had undergone elective abdominal aortic aneurysm (AAA) repair showed that almost half of them (43.1 %) had impaired passability of the inferior mesenteric artery (IMA), 19.3 % – of the internal iliac artery (IIA) and both arteries were affected in 8.3 % of the patients. IMA after elective AAA repair was ligated in 130 patients, 65 patients had it implanted into prosthesis and 2 patients underwent stenting of the aorta. The operation resulted in preserved antegrade and retrograde blood flow in the IIA in a quarter (25.4 %) and a third (32.1 %) of the patients, respectively. In the early postoperative period ischemic colitis was found in 8 patients (4.1 %), and more than a third of them (37.5 %) developed infarction in the left side of the colon with a lethal outcome. To objectify the intraoperative assessment of the blood supply in the left colon after elective AAA repair the methods of direct manometry and ultrasonography were used in 41 and 40 patients, respectively, and both methods were applied in 21 patients. The level of statistical significance and the positive values of the coefficients of correlation between the values of the peak systolic velocity and the indices of pressure intraoperative ultrasonography as a reliable and noninvasive method for assessing perfusion in the left side of the colon after electively AAA repair.
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