[The prevention of the aorto-mesenteric compression syndrome in interventions for ileoanal anastomoses].
Restorative proctocolectomy with ileal-anal anastomosis can induce a duodenal stenosis due to the compression between superior mesenteric artery (SMA) and aorta when the ileum is pulled-down to the anus stretching the SMA. This situation may require prolonged nasogastric intubation or even surgery. In our experience this occurred in 10% of pts. Aiming to avoid this complication we have performed an intestinal derotation just before ileal-anal anastomosis abolishing any possibility of duodenal compression. Comparing this latter group of patients to those who didn't receive intestinal derotation, we observed a significant reduction of nasogastric tube drainage and of the nasogastric intubation time. We think that intestinal derotation could be effective in preventing SMA syndrome after restorative proctocolectomy and ileal-anal anastomosis.
Tonelli
F
F
Dipartimento di Fisiopatologia Clinica, Università di Firenze.
Anastasi
A
A
Mazzoni
P
P
Batignani
G
G
Monaci
I
I
Ferretti
P
P
Ficari
F
F
D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D016737:Proctocolectomy, Restorative / Q000009:adverse effects* / Q000379:methods; D013478:Superior Mesenteric Artery Syndrome / Q000517:prevention & control*
Prevenzione della sindrome del compasso aorto-mesenterico negli interventi di ileo-ano-anastomosi.