[Studies on operative method in intestinal hemodynamics of panperitonitis]

Using a tissue spectrum analyser, intestinal hemodynamics were determined in 85 patients with panperitonitis. By the preoperative shock score(ss) the patients were classified into group I (ss less than or equal to 1: n = 30), group II (2 less than or equal to ss less than or equal to 4: n = 30), group III (5 less than or equal to ss: n = 25). The index of hemoglobin concentration (IHb) was increased in group II, while the index of oxygen saturation (ISO2) was decreased in groups I and II. There was an increase of the cardiac 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.