Abstract
Purpose
Massive bowel resection is often performed for superior mesenteric arterial (SMA) occlusion, resulting in short bowel syndrome. We conducted this study to evaluate the effectiveness of open abdomen management to monitor the blood flow of the remnant bowel and anastomoses.
Methods
We treated five of seven patients with SMA occlusion by open abdomen management, with or without mesh, using a zipper, which we opened daily to monitor the blood flow around the anastomotic site.
Results
None of the five patients treated by open abdomen management required re-resection of the remnant bowel and they were all discharged from hospital in a stable condition.
Conclusion
Open abdomen management proved extremely useful for monitoring blood flow to the anastomotic site and for allowing complete drainage into the abdominal space. Using this method would assist in leaving as much remnant bowel as possible after resection for SMA occlusion.
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References
JS Thompson (1994) ArticleTitleManagement of the short bowel syndrome Gastrointest Clin North Am 23 403–20 Occurrence Handle1:STN:280:ByuA2M%2FkvFc%3D
JK DiBaise RJ Young JA Vanderhoof (2004) ArticleTitleIntestinal rehabilitation and the short bowel syndrome: part 1 Am J Gastroenterol 99 1386–95 Occurrence Handle15233682
D Ward AM Vernava DL Kaminski T Ure G Peterson P Garvin et al. (1995) ArticleTitleImproved outcome by identification of high-risk nonocclusive mesenteric ischemia, aggressive reexploration, and delayed anastomosis Am J Surg 170 577–80 Occurrence Handle10.1016/S0002-9610(99)80019-1 Occurrence Handle1:STN:280:BymD1MvnvVU%3D Occurrence Handle7492004
H Mitsuoka N Unno T Sakuirai H Kaneko S Suzuki H Konno et al. (1999) ArticleTitlePathophysiological role of endothelins in pulumonary micro-circulatory disorders due to intestinal ischemia and reperfusion J Surg Res 87 143–51 Occurrence Handle10.1006/jsre.1999.5694 Occurrence Handle1:CAS:528:DyaK1MXnvFarurw%3D Occurrence Handle10600343
H Mitsuoka E Kistler Schmid-Schonbein (2000) ArticleTitleProduction of in-vivo activators in the ischemic intestine Proc Natl Acad Sci USA 97 1772–7 Occurrence Handle10.1073/pnas.97.4.1772 Occurrence Handle1:CAS:528:DC%2BD3cXhsFCrt7g%3D Occurrence Handle10677533
H Amano (1982) ArticleTitleStudies on the relationship between tissue oxygen tension and anastomotic healing of ischemic small intestine in dog and human Jpn Surg Soc 83 1398–410
S Sakaguchi K Minowa T Shibanushi M Ichino H Mitsuoka N Unno et al. (2002) ArticleTitleRevascularization to prevent postoperative bowel infarction after surgery for acute superior mesenteric artery thromboembolism Surg today 32 243–8 Occurrence Handle10.1007/s005950200028 Occurrence Handle11991510
P Clavien C Muller F Harder (1987) ArticleTitleTreatment of mesenteric infarction Br J Surg 74 500–3 Occurrence Handle1:STN:280:BiiB2s3js1I%3D Occurrence Handle3607410
PA Clavien M Durig F Harder (1988) ArticleTitleVenous mesenteric infarction: a particular entity Br J Surg 75 252–5 Occurrence Handle1:STN:280:BieC28vivV0%3D Occurrence Handle3349333
BH Saggi HJ Surgermann RR Ivatury et al. (1998) ArticleTitleAbdominal compartment syndrome J Trauma 45 597–609 Occurrence Handle1:STN:280:DyaK1cvit1Wkug%3D%3D Occurrence Handle9751558
JF Daff J Moffat (1981) ArticleTitleAbdominal sepsis managed by leaving the abdomen open Surgery 90 774–8
JL Garcia-Sabrio JM Tallado NV Christou JF Polo E Valdecantos (1988) ArticleTitleTreatment of severe intra-abdominal sepsis and/or necrotic foci by an “open-abdomen” approach. Zipper and zipper- mesh techniques Arch Surg 123 152–6
AL Adkins J Robbins M Villalba P Bendick CJ Shanley (2004) ArticleTitleOpen abdomen management of intra-abdominal sepsis Am Surg 70 137–40 Occurrence Handle15011916
SH Giles JW Marvin APH McLean LM Jonathan (1986) ArticleTitleThe septic abdomen: Open management with Marlex mesh with a zipper Surgery 99 399–407
DJ Muckart S Bhagwanjee (1997) ArticleTitleAmerican college of chest physicians/society critical care medicine consensus conference definitions of the systemic inflammatory response syndrome and allied disorders in relation to critically injured patients Crit Care Med 25 1789–95 Occurrence Handle1:STN:280:DyaK1c%2FjtlGmtg%3D%3D Occurrence Handle9366759
K Arakawa I Takeyoshi M Muraoka K Matsumoto Y Morishita (2004) ArticleTitleMesuring platelet aggregation to estimate small intestinal ischemia-reperfusion injury J Surg Res 122 195–200 Occurrence Handle10.1016/j.jss.2004.07.011 Occurrence Handle1:CAS:528:DC%2BD2cXhtVSnsbnO Occurrence Handle15555618
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Mimatsu, K., Oida, T., Kanou, H. et al. Open Abdomen Management After Massive Bowel Resection for Superior Mesenteric Arterial Occlusion. Surg Today 36, 241–244 (2006). https://doi.org/10.1007/s00595-005-3142-0
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DOI: https://doi.org/10.1007/s00595-005-3142-0