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Rivista di Angiologia
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899
International Angiology 2016 Mar 25
Continuous “Air” tonometry of the sigmoid colon during abdominal aortic surgery
Stylianos KOUTSIAS 1, Dimitrios PAPADIMITRIOU 2, Konstantinos SPANOS 1, Athanasios G. GIANNOUKAS 1 ✉
1 Department of Vascular Surgery, University Hospital of Larisa, Greece; 2 Department of Vascular Surgery, ‘G.GENNIMATAS’ Hospital of Thessaloníki, Greece
BACKGROUND: To record the changes in the mucosal pHi of the sigmoid colon during operations of the abdominal aorta, using the “air” tonometry method.
METHODS: Patients with abdominal aortic aneurysm (AAA), and with aortoiliac occlusive disease (AIOD) were included in the study. The tonometric catheter was placed in the sigmoid colon under colonoscopy, and its position was confirmed during operation. The pHi records were divided into certain phases: 1) beginning 2) clamping 3) declamping 4) Intensive Care Unit 5) 1st day in the ICU, 6) 2nd day in the ICU.
RESULTS: A total of 30 male patients (15 with AAA, 15 with AIOD) were enrolled in the study. Dyslipidemia, arterial hypertension and coronary heart disease were present in the majority of the patients in both groups. In the AAA group, a significant difference (p =0.004) was present between at least two time phases regarding the pHi time course. Comparison of the pH(r-a) (regional pH – arterial pH) values in both groups of patients showed a statistically significant result (p=0.008). Regarding P(r-a)CO2 (regional pCO2 – arterial pCO2) course, a statistically significant difference in the P(r-a)CO2 course from one time phase to another in both groups was noticed. (p<0.001).
CONCLUSIONS: Air tonometry (TONOCAP) is an effective and easily applicable method, allowing the surgeon to be better informed of the tissue oxygenation of the intestinal wall, for the prevention of colon ischemia complications and to take the appropriate measures.