J.Jpn. Surg. Soc.. 84(1): 40-50, 1983
Original article
EXPERIMENTAL STUDIES ON THE SELECTIVE PROFOUND HYPOTHERMIA OF THE ABDOMINAL VISCERA BY DESCENDING AORTA AND INFERIOR CAVAL VEIN OCCLUSION
|
Department of Gastroenterological Surgery, Jichi Medical School, Tochigi, Japan Sumio Tenmoku |
In 6 mongrel dogs, hemodynamic changes were investigated during 60 minutes normothermic vascular exclusion of the abdominal viscera by occluding the aorta and inferior caval vein just above the diaphragm. Hemodynamic state just after the combined occlusion of these vessels was stable, but 60 minutes occlusion was followed by hypoperfusion of the cranial half of the body.
In 15 mongrel dogs, the 60 minutes selective profound hypothermia below 20℃ of the abdominal viscera was performed after occluding these vessels with an aid of extracorporeal circuit. Pooled blood in the splanchnic region during hypothermia was warmed and drained to jugular vein to maintain the hemodynamic state in the cranial half of the body. Twelve of 15 dogs survived 2 weeks after the procedure with minimal hepatic damage.
In 7 mongrel dogs, blood coagulation system was investigated. Decrease of platelet, fibrinogen, plasminogen, anti-thrombin III, prothrombin and cold insoluble globulin concentration, elongation of prothrombin time and partial thromboplastin time, and elevation of FDP occurred during and after the selective profound hypothermia. But these changes were self limiting and recovered soon after heparin neutralization.
In 9 mongrel dogs, extended pancreatectomy with splenectomy and combined resection of portal vein using selective profound hypothermia was performed. Bleeding and splanchnic congestion during extended pancreatectomy was minimum. Five of 9 dogs survived 2 weeks with slight hepatic and renal damage.
To read the PDF file you will need Adobe Reader installed on your computer.