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  • Title: Tonometric assessment of sigmoid perfusion during aortobifemoral reconstruction for arteriosclerosis.
    Author: Kuttila K, Perttila J, Vänttinen E, Niinikoski J.
    Journal: Eur J Surg; 1994 Sep; 160(9):491-5. PubMed ID: 7849168.
    Abstract:
    OBJECTIVE: To assess the effect of inferior mesenteric artery reimplantation on perfusion of the mucosa of the sigmoid colon in patients undergoing aortobifemoral reconstruction for arteriosclerotic disease. DESIGN: Random control study. SETTING: University hospital. SUBJECTS: 8 Men and 2 women with peripheral vascular disease and angiographically patent superior and inferior mesenteric arteries. INTERVENTIONS: Patients were randomised to have the inferior mesenteric artery reimplanted in the Y-graft or not. Sigmoid perfusion was measured with a tonometer and expressed as the intramucosal pH (pHi) during operation (baseline) and for four days afterwards. MAIN OUTCOME MEASURES: Measurements of pHi, arterial blood gases, and acid base balance, and signs of ischaemia of the gut. RESULTS: In both groups the pHi was reduced after clamping the aorta, but returned to baseline on the first postoperative day. One patient had a cardiac arrest from which he was resuscitated and his pHi measurements were subsequently low. CONCLUSION: pHi does seem to reflect changes in the circulation of the sigmoid mucosa. Even if the inferior mesenteric artery is patent, reimplantation is only rarely indicated in patients undergoing aortobifemoral reconstruction.
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