[Gastrointestinal complications and their prevention after abdominal aortic reconstruction, especially factors and prevention of paralytic intestinal ileus after a abdominal bifurcated grafting operation].
We experienced 66 cases of abdominal aortic repair, which contained 49 cases of abdominal aortic aneurysm (AAA) and 17 cases of high leveled arteriosclerotic occlusion (high ASO), since March, 1977 till December, 1985. Operative procedures were 44 cases of Y-graft replacement and 5 cases of tube graft interposition for all of AAA, and Y bypass grafting for high ASO. As early gastrointestinal complications after these repairs, paralytic intestinal ileus was found 9 cases in AAA group and no case in high ASO group. Mechanical intestinal ileus needed surgical lysis was found one case in AAA group and one case in high ASO group, upper gastrointestinal bleeding was found 2 cases in both groups, transient ischemic colitis 4 cases in AAA group, and liver dysfunction 4 cases in AAA group. The most frequent complication was paralytic intestinal ileus. In the comparison between 9 cases of paralytic intestinal ileus and others, operative time of the former was significantly longer than that of the latter. But there were no differences in the incidence of other factors. We think that, operative procedure must be chosen in consideration of shortening the operative time. And careful management of gastrointestinal tract and pre-operative correction of general conditions, especially the correction of serum electrolytes and nutrition are the most important.
D000368:Aged; D001012:Aorta, Abdominal / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D001161:Arteriosclerosis / Q000601:surgery; D001807:Blood Vessel Prosthesis; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000209:etiology* / Q000517:prevention & control; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*