[Studies on operative method in intestinal hemodynamics of panperitonitis].
Using a tissue spectrum analyser, intestinal hemodynamics were determined in 85 patients with panperitonitis. By the preoperative shock score(ss) the patients were classified into group I (ss less than or equal to 1: n = 30), group II (2 less than or equal to ss less than or equal to 4: n = 30), group III (5 less than or equal to ss: n = 25). The index of hemoglobin concentration (IHb) was increased in group II, while the index of oxygen saturation (ISO2) was decreased in groups I and II. There was an increase of the cardiac index and a decrease of total peripheral resistance in group III compared with other groups, indicating a hyperdynamic state. Oxygen delivery and consumption showed no marked changes in groups I and II, but they were impaired in group III. The incidence rate of anastomotic leakage was 0% in group I, 37.5% in group II, and 100% in group III. It was considered that in the group II patients, a decrease in tissue oxygenation caused by stagnation of blood flow becomes a cause of anastomotic leakage. In the group III patients, tissue damage caused by marked disturbances of oxygen delivery and consumption leads to a high incidence of anastomotic leakage. I concluded that the second look operation should be performed for the patients with the disturbance of oxygen delivery and consumption.
Hosokawa
T
T
First Department of Surgery, Kurume University School of Medicine, Japan.
D000328:Adult; D000368:Aged; D000818:Animals; D004285:Dogs; D005260:Female; D006439:Hemodynamics; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D010538:Peritonitis / Q000503:physiopathology / Q000601:surgery*; D012039:Regional Blood Flow; D012086:Reoperation; D013514:Surgical Procedures, Operative / Q000379:methods; D014655:Vascular Resistance
D006454:Hemoglobins; D010100:Oxygen