INTESTINAL AND COLONIC ISCHAEMIA IN THE SURGERY OF SUBDIAPHRAGMATIC AORTA

Abstract

Ischemic colitis resulting in colonic infarction after aortic reconstruction is a highly lethal complication. The etiology and pathogenesis of this condition demonstrate that in many instances it may be prevented. Early recognition, particularly of the tra n s m u ral ischemic injury, is essential. Numerous techniques used during surgery for assessing the adequacy of colonic perfusion have been evaluated and found to be inaccurate in terms of predicting colonic ischemia. The purpose of this study is to assess the mains monitoring technique for prediction of ischemic colitis during aortic surgery as: colonic mesenteric Doppler signals, inferior mesenteric arteries stump pre s s u re, sigmoidal intra m u c o sal pH and measurement of mucosal capillary haemoglobin oxygen saturation by reflectance spectrophotometry. A 15-year experience with 1912 patients undergoing abdominal aortic re c o n s t ruction was re v i e wed to determinated both the incidence of intestinal ischemia and the clinical, anatomic, and technical factors associated with this complication of aortic surgery.