Document Detail


Omental pedicle graft to improve ischemic anastomoses.
MedLine Citation:
PMID:  7685127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An end-to-end anastomosis was done in the center of a 5-cm devascularized jejunal segment in 5 control laboratory rabbits and 14 experimental rabbits. A second group consisted of 5 control animals and 11 experimental animals having end-to-end jejunojejunostomy in the center of a 10-cm devascularized jejunal segment. In the experimental animals, the anastomosis was wrapped circumferentially by a vascularized omental pedicle. Anastomotic leaks or fistulas developed in five 10-cm controls (100%), five 5-cm controls (100%), nine 10-cm omental wraps (82%), and four 5-cm omental wraps (29%). The remaining animals had strictures of various degrees. Injection of methylene blue into the omental vessels showed perfusion to the mucosa from the omentum. The difference between the 10-cm segment and the 5-cm segment indicates some limitation to the available blood flow from the omentum. The anastomotic stricturing was due to ischemic injury before reperfusion by ingrowth of omental vessels. A vascularized omental pedicle wrap can augment blood flow; however, the time required for neovascular ingrowth allows ischemic mucosal injury if there is no other available blood supply.
Authors:
B L Dockendorf; R C Frazee; R G Matheny
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Southern medical journal     Volume:  86     ISSN:  0038-4348     ISO Abbreviation:  South. Med. J.     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-07-07     Completed Date:  1993-07-07     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  628-32     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Scott & White Clinic and Memorial Hospital, Scott, Sherwood and Brindley Foundation, Temple, TX 76508.
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MeSH Terms
Descriptor/Qualifier:
Anastomosis, Surgical
Animals
Colonic Diseases / etiology
Intestinal Fistula / etiology
Ischemia
Jejunal Diseases / etiology
Jejunostomy
Jejunum / blood supply*,  pathology,  surgery*
Neovascularization, Pathologic / pathology
Omentum / transplantation
Postoperative Complications
Rabbits
Surgical Flaps / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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