Indications and procedures for second-look surgery in acute mesenteric ischemia.
Acute mesenteric ischemia (AMI) is a highly lethal clinical entity associated with high morbidity and mortality. Bowel necrosis often results, usually necessitating bowel resection; however, deciding on the extent of resection is problematic as accurate identification of ischemic bowel that may undergo subsequent infarction is difficult. Therefore, a second-look laparotomy after the first operation is usually recommended. While the second-look procedure is widely accepted, its optimal indications and mode are still controversial, raising questions such as "second-look or not?," "planned relaparotomy or relaparotomy on demand?," and "open or laparoscopic?" In this review we discuss the relevant literature and reassess the role of the second-look operation in the treatment of AMI.
Meng
Xianzhi
X
Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Harbin, 150001, Heilongjiang Province, PR China.
Liu
Lianxin
L
Jiang
Hongchi
H
D000208:Acute Disease; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D006801:Humans; D007410:Intestinal Diseases / Q000601:surgery; D007422:Intestines / Q000098:blood supply* / Q000601:surgery; D007511:Ischemia / Q000601:surgery*; D008638:Mesenteric Arteries; D008641:Mesenteric Vascular Occlusion / Q000601:surgery*; D008643:Mesentery / Q000601:surgery*; D012086:Reoperation / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D024162:Second-Look Surgery / Q000295:instrumentation / Q000379:methods*