Transanal laser Doppler flowmetry to assess microcirculation in the upper rectum during abdominal aortic aneurysmectomy.
OBJECTIVE
Fatal ischemic colitis can develop after abdominal aortic aneurysmectomy. We investigated the effectiveness of transanal laser Doppler flowmetry (LDF) for assessing microcirculation in the rectal mucosa during aneurysm repair.


METHODS
The subjects were 17 patients who underwent abdominal aortic aneurysmectomy. A Doppler laser and Doppler probe were mounted on a rectoscope, which was inserted into the anus, and rectal flux values were obtained by a flowmeter.


RESULTS
The mean flux value during aortic clamping was 146 +/- 35.6 perfusion units (PU) in patients with sufficient collateral circulation to the upper rectum and 58.3 +/- 19.4 PU in patients with insufficient collateral circulation ( P << 0.01). The LDF values and inferior mesenteric artery stump pressure measurements were well correlated ( r = 0.86).


CONCLUSIONS
Transanal rectal LDF is useful for continuously assessing microcirculation in the rectal mucosa during abdominal aneurysmectomy, and the data obtained with this method may reflect whether a collateral pathway to the upper rectum exists.
Matsukura
Ichiro
I
Department of Surgery, Division of Vascular Surgery, Tokyo Medical and Dental University, School of Medicine, 1-5-45 Yushima, Bunkyo-ku, 113-8519 Tokyo, Japan.
Inoue
Yoshinori
Y
Iwai
Takehisa
T
D000328:Adult; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D020685:Colonoscopes; D003113:Colonoscopy / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011336:Probability; D012007:Rectum / Q000098:blood supply*; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014463:Ultrasonography; D014656:Vascular Surgical Procedures / Q000379:methods