直近一年間の累計
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ID 117310
タイトル別表記
Colon Hypoperfusion After Artery Ligation
著者
東島, 潤 The University of Tokushima KAKEN研究者をさがす
Kono, Toru The University of Tokushima|Sapporo Higashi Tokushukai Hospital
Sugitani, Ayumu Sapporo Higashi Tokushukai Hospital
吉川, 幸造 The University of Tokushima KAKEN研究者をさがす
キーワード
anterior rectal resection
ileocecal resection
hypoperfusion
artery ligation
anastomotic leakage
資料タイプ
学術雑誌論文
抄録
Background: Anastomotic leakage (AL) after colorectal surgery is associated with insufficient vascular perfusion of the anastomotic ends. This study aimed to evaluate the effect of high vs. low ligation of the ileocolic artery and inferior mesenteric artery, respectively, on the vascular perfusion of the bowel stumps during ileocecal resection (ICR) and anterior rectal resection (AR).
Methods: We retrospectively evaluated patients who underwent ICR or AR between 2016 and 2020. Real-time indocyanine green fluorescence angiography was performed to measure the fluorescence time (FT) as a marker of the blood flow in the proximal and distal stumps before anastomosis.
Results: Thirty-four patients with lower right-sided colon cancer underwent laparoscopic ICR. Forty-one patients with rectosigmoid colon or rectal cancer underwent robotic high AR (HAR) (n = 8), robotic low AR (LAR) (n = 6), laparoscopic HAR (n = 8), or laparoscopic LAR (n = 19). The FT was similar in the ileal and ascending colon stumps (p = 1.000) and did not differ significantly between high vs. low ligation of the ileocolic artery (p = 0.934). The FT was similar in the sigmoid colon and rectal stumps (p = 0.642), but high inferior mesenteric artery ligation significantly prolonged FT in the sigmoid colon during AR compared with low ligation (p = 0.004), indicating that the high ligation approach caused significant hypoperfusion compared with low ligation. The AL rate was similar after low vs. high ligation.
Conclusions: Low vascular perfusion of the bowel stumps may not be an absolute risk factor for AL. High inferior mesenteric artery ligation could induce sigmoid colon stump hypoperfusion during anterior rectal resection.
掲載誌名
Frontiers in Surgery
ISSN
2296875X
出版者
Frontiers Media S.A.
8
開始ページ
756873
発行日
2021-12-13
権利情報
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
病院
医学系