|
|
 |
 |
| |
 Printable version |
Postoperative ischaemic colitis |
Sang Thrombose Vaisseaux. Volume 11, Number 1, 23-9, Janvier 1999, Mini-revues
|
 Résumé
Article gratuit
|
Author(s) : Michel Batt, Réda Hassen-Khodja, Serge Declemy |
Summary : Ischaemic colitis is a rare but serious complication of aorto-iliac surgery. It occurs electively in the left side of the colon. There are many causes of postoperative ischaemic colitis. Prevention depends essentially on the respect of the revascularisation of the left colon. Preoperative assessment of arteriography allows identification of colons at risk either by stenosis of the superior mesenteric artery or a patent inferior mesenteric artery. Prevention of ischaemia requires stable blood pressure during and after surgery, the shortest possible clamp time of a patent inferior mesenteric artery to avoid the ischaemia/reperfusion syndrome. There are many peroperative methods of detecting ischaemic colitis. Measurement of the residual pressure in the inferior mesenteric artery is the commonest technique in clinical practice. At present, there is no consensus on the need to revascularise a patent inferior mesenteric artery in order to prevent postoperative ischaemic colitis: some teams do so systematically whereas others perform selective revascularisation (when the systolic index in inferior to 0.40). The role of the internal iliac arteries in the prevention of postoperative ischaemic colitis is discuss-ed. Some suggest that at least one internal iliac artery should be revascularised especially when the inferior mesenteric artery is occluded. Some recent studies show that the internal iliac arteries play an accessory part in the prevention of postoperative ischaemic colitis. |
Keywords : |
|
