Comparison of Methods to Determine Viability of Small Intestine

Bussemaker, J.; Lindeman, J.

doi:10.1097/00000658-197207000-00017

Cited by 61 publications

(11 citation statements)

References 3 publications

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“…Subjective clinical assessment of tissue perfusion during operation is often unreliable and speculative [10,11], Most of the methods being developed are only useful for experi mental laboratory studies and not applicable to routine use in patients [4,[12][13][14]. Sheridan et al [5] 15.4 mm Hg, to the descending colon, lowest PtC>2 29.3 ± 11.0 mm Hg.…”

Section: Discussionmentioning

confidence: 99%

Anastomotic Tissue Oxygen Tension during Esophagectomy in Patients with Esophageal Carcinoma

et al. 1996

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Submucosal tissue oxygen tension (PtO₂) was measured in 20 patients with cervical esophagogastrostomy after resection of esophageal carcinoma, using a Clark-type oxygen electrode. The mean gastric baseline PtO₂ was 54.6 ± 10.7 mm Hg. Following ligature of the vasa brevia and the left gastroepiploic artery PtO₂ decreased to 45.8 ± 9.9 mm Hg, ligature of the left gastric artery caused a decrease to 34.2 ± 9.7 mm Hg and resection of the lesser curvature and pulling up of gastric tube led to 25.5 ± 9.0 mm Hg. Clinical value and practicability of intraoperative PtO₂ measurements could be proven.

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Section: Discussionmentioning

confidence: 99%

Anastomotic Tissue Oxygen Tension during Esophagectomy in Patients with Esophageal Carcinoma

et al. 1996

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“…A major difficulty facing surgeons dealing with acute ischaemia of the small intestine is the inability to predict accurately the viability of revascularised intestine (Bussemaker et al, 1972;Skinner et al, 1974). Intestine which is pink with visible pulsation in its walls may become gangrenous after its return to the abdomen.…”

Section: Necropsy Resultsmentioning

confidence: 99%

Effect of intraluminal oxygen on experimental ischaemia of the intestine.

Shute¹

1976

Gut

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SUMMARY The small bowel of 44 rats has been made ischaemic for 120 minutes by occluding the superior mesenteric artery. Gaseous oxygen was introduced into the small bowel lumen of 18 of the rats, and gaseous nitrogen into the bowel lumen of a further eight, 30 minutes after the start of the ischaemia. The mortality rate of thecontrolgroup of 18 rats was 89 %, significantlyhigher than the 39 % mortality of the oxygen-treated rats (p < 0 005). None of the eight rats treated with intraluminal nitrogen survived. Histological changes caused by ischaemia were much reduced in the intestine of the oxygen treated rats.

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“…Previous investigations of morphologic and electro myographic changes in experimental small bowel isch emia demonstrated that irreversible damage of the bowel wall must be suspected after 4-6 h of complete ischemia, depending upon the species chosen [4,10,11,22,27], We started thrombolysis after 3 h of ischemia at the latest to avoid irreversible changes. The dose of streptokinase was equal to that used in local thrombolysis of acute arterial thrombosis in humans [15],…”

Section: Discussionmentioning

confidence: 99%

“…Despite the development of sophisticated radiological techniques in the diagnosis of small bowel ischemia [3,7], the clinical problems related to the viability of isch emic bowel are still unsolved [1], The angiographic pic ture of a patent superior mesenteric artery (SMA) as well as the intraoperative findings of arterial pulsations, the return of mesenteric bleeding and the onset of normal color patterns are poor guides to viability [4,11]. Both radiological and intraoperative signs indicate the restora tion of the circulation only, but do not give objective information about ischemic injury to the intestinal wall, persistent disturbances of the intestinal microcirculation, and the damage due to reoxygenation of the ischemic tis sue [18,24], Compared to mesenteric angiography, oxy gen pressure histograms provide real-time assessment of oxygen perfusion and oxygen transport [6,12,13,19,20].…”

Section: Introductionmentioning

confidence: 99%

Functional and Morphological Changes of the Small Bowel after Experimental Embolic Occlusion and Local Thrombolysis of the Superior Mesenteric Artery

Lausen¹,

Schöffel²,

Ruf³

et al. 1986

Dig Surg

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Following embolization of the superior mesenteric artery with autologous blood clots, local catheter thrombolysis using streptokinase was performed in 14 pigs. In 7 animals the abdomen was kept closed during the time of obstruction (3 h) and subsequent lysis (up to 3 h) until angiography revealed patent vessels. Macroscopic and histologic examination showed small bowel distension and severe mucosal damage in all animals. In a second series of 7 pigs, lysis was performed after 1 2 and 3 h of ischemia. Angiographic and histologic findings were compared with surface oxygen tension and myoelectrical activity. Bowel wall anoxia and disappearance of slow waves were reversible after up to 4 h of ischemia (2 h occlusion, 1–2 h lysis). Persistent anoxia and irreversible disappearance of slow waves in combination with severe mucosal damage were suggestive of pregangrenous alterations of the small bowel despite a normal angiographic pattern beyond 3 h of obstruction and successful lysis. The results demonstrate that angiography alone is of poor predictive value in determining bowel viability in acute intestinal ischemia.

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Comparison of Methods to Determine Viability of Small Intestine

Cited by 61 publications

References 3 publications

Anastomotic Tissue Oxygen Tension during Esophagectomy in Patients with Esophageal Carcinoma

Anastomotic Tissue Oxygen Tension during Esophagectomy in Patients with Esophageal Carcinoma

Effect of intraluminal oxygen on experimental ischaemia of the intestine.

Functional and Morphological Changes of the Small Bowel after Experimental Embolic Occlusion and Local Thrombolysis of the Superior Mesenteric Artery

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