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High tie of the inferior mesenteric artery in distal colorectal resections--a safe vascular procedure.

Abstract：

:Division of the inferior mesenteric artery flush with the aorta (high tie) allows a tension-free anastomosis in distal colorectal resections but may also diminish the blood supply. Tissue oxygen tension was measured proximal to the resection margin before and after either low or high division of the inferior mesenteric artery in 62 patients undergoing elective colorectal resections. Oxygenation was maintained or improved when the transverse (median change after vs before resection for low tie +9 mmHg (P < 0.05), high tie +8 mmHg (P = 0.3)) and descending colon (low tie +7 mmHg (p < 0.01), high tie +1 mmHg (p = 0.67)) were used for the anastomosis but diminished for sigmoid anastomoses (low tie -4 mmHg (P = 0.42), high tie -9 mmHg (P < 0.05)). Change in oxygenation was significantly affected by location of proximal resection site but not by choice of high or low tie. These results suggest that the marginal artery provides a more than adequate vascular supply to the transverse and descending colon, but that the sigmoid colon is not suitable for anastomosis. We conclude that the sigmoid colon be sacrificed and there should be no hesitation in performing a high tie to avoid tension in low pelvic anastomoses.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Hall NR,Finan PJ,Stephenson BM,Lowndes RH,Young HL

doi

10.1007/BF00337583

subject

Has Abstract

pub_date

1995-01-01 00:00:00

pages

29-32

issue

1

eissn

0179-1958

issn

1432-1262

journal_volume

10

pub_type

杂志文章

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