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Endoscopy-based early enterostomy closure for superior mesenteric arterial occlusion. 2010

Takatsugu Oida, and Hisao Kano, and Kenji Mimatsu, and Atsushi Kawasaki, and Youichi Kuboi, and Nobutada Fukino, and Sadao Amano
Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama 231-8553, Japan. ooida.takatsugu@yokochu.jp

OBJECTIVE To evaluate the efficacy of endoscopic examination of blood flow and edema in the remnant bowel. METHODS We retrospectively studied 15 patients who underwent massive bowel resection with enterostomy for superior mesenteric arterial occlusion (SMAO); the patients were divided into a delayed closure group (D group) and an early closure group (E group). RESULTS The mean duration from initial operation to enterostomy closure was significantly shorter in the E group (18.3 +/- 2.1 d) than in the D group (34.3 +/- 5.9 d) (P < 0.0001). The duration of hospitalization after surgery was significantly shorter in the E group (33 +/- 2.2 d) than in the D group (51 +/- 8.9 d) (P < 0.0002). CONCLUSIONS Endoscopic examination of blood flow and edema in the remnant bowel is useful to assess the feasibility of early closure of enterostomy in SMAO cases.

UI MeSH Term Description Entries
D008297 Male Males
D008641 Mesenteric Vascular Occlusion Obstruction of the flow in the SPLANCHNIC CIRCULATION by ATHEROSCLEROSIS; EMBOLISM; THROMBOSIS; STENOSIS; TRAUMA; and compression or intrinsic pressure from adjacent tumors. Rare causes are drugs, intestinal parasites, and vascular immunoinflammatory diseases such as PERIARTERITIS NODOSA and THROMBOANGIITIS OBLITERANS. (From Juergens et al., Peripheral Vascular Diseases, 5th ed, pp295-6) Mesenteric Vascular Occlusions,Occlusion, Mesenteric Vascular,Occlusions, Mesenteric Vascular,Vascular Occlusion, Mesenteric,Vascular Occlusions, Mesenteric
D008643 Mesentery A layer of the peritoneum which attaches the abdominal viscera to the ABDOMINAL WALL and conveys their blood vessels and nerves. Mesenteries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D004766 Enterostomy Creation of an artificial external opening or fistula in the intestines. Enterostomies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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