J.Jpn. Surg. Soc.. 92(11): 1583-1592, 1991

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Original article

STUDIES ON OPERATIVE METHOD IN INTESTINAL HEMODYNAMICS OF PANPERITONITIS

Using a tissue spebtrum analyser, intestinal hemodynamics were determined in 85 patjents with panperitonitis. By the preoperative shock score (ss) the patierits were classified into group I (ss≦1:n=30), group II (2≦ss≦4:n=30), group III (5≦ss:n=25).
The index of hemoglobin concentration (IHb) was increased in group ll, while the index of oxygen saturation (ISO₂) was decreased in groups I and II.
There was an increase of the bardiac index and a decrease of total peripheral resistance in group III compared with other groups, indicating a hyperdynamic state.
Oxygen delivery and consumption showed no marked changes in groups I and II, but they were impaired in group III. The incidence rate of anastomotic leakage was 0% in group I, 37.5% in group II, and 100% in group III.
It was considered that in the group II patients, a decrease in tissue oxygenation caused by stagnation of blood flow becomes a cause of anastomotic leakage. In the group III patients, tissue damage caused by marked disturbances of oxygen delivery and consumption leads to a high incidence of anastomotic leakage. I concluded that the second look operation should be performed for the patients with the disturbance of oxygen delivery and consumption.

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