Intestinal function and intestinal blood supply: a 20 year surgical study

Area of Science:

• Vascular Surgery
• Gastroenterology
• Interventional Radiology

Background:

• Chronic intestinal arterial occlusion (IAO) poses diagnostic and management challenges.
• Limited data exists on long-term outcomes of surgical interventions for IAO.

Purpose of the Study:

• To present the 20-year experience of Middlesex Hospital in diagnosing and managing IAO.
• To evaluate the effectiveness and outcomes of surgical reconstruction for IAO.

Main Methods:

• Retrospective review of 100 referred patients over 20 years.
• Critical evaluation of 28 diagnosed IAO patients based on absorptive and excretory function.
• Analysis of surgical reconstruction outcomes for coeliac axis and mesenteric arteries.

Main Results:

• Only 28 of 100 referred patients had IAO; no correlation found between intestinal function and angiographic ischemia.
• Twenty-two patients underwent arterial reconstruction with three perioperative deaths.
• Of the remaining patients, 15 were asymptomatic, one unchanged, and one subjectively worse after 6 months to 10 years of follow-up.

Conclusions:

• Surgical reconstruction of visceral arteries can be effective for selected IAO patients.
• Elective surgery for IAO requires careful consideration of risks and benefits based on individual patient factors and global experience.