关键词: 急性肠系膜血管缺血, 损伤控制性外科, 早期确定性手术

Abstract:

Early definitive intestinal anastomosis in acute mesenteric ischemia:a preliminary report        LI You-sheng,WU Xing-jiang,WANG Jian,et al.Department of Surgery, Nanjing General Hospital of Nanjing Command, Nanjing 210002, China
Corresponding author:LI Jie-shou, E-mail: Guttx@yahoo.com
Abstract    Objective    To investigate the possibility of early definitive intestinal anastomosis in acute mesenteric schaemia. Method    Ten patients with acute mesenteric ischemia from Jan. 2008 to Sep. 2009 were reviewed retrospectively. All patients were diagnosed with DSA and/or CT. Early relaparotomy and restoration of intestinal continuity were performed no more than 8 days after first laparotomy. All patients were followed in outpatients clinic more than 6 months. Results  Ten patients underwent early restoration of intestinal continuity within 5-8（5.6±2.3）days of the first postoperative laparotomy,3 of 10 patients were performed embolectomy. Four patients had anastomotic fistulas and were treated with non-surgical procedures successfully. All patients were weaned from parenteal nutrition and 1 patient required partially enteral nutrition postoperative 6 months. Conclusion    Under the guidance of damage control surgery, early definitive intestinal anastomosis may be used safely in a selected group of patients with AMI, with potential advantages of early definitive intestinal anastomosis and lower mortality. However, the patients had higher risk of anastomotic fistula and needed longer period parenteral and/or enteral nutrition.

Key words: acute mesenteric ischemia, damage control surgery, early restoration of intestinal continuity