New Methods for Determining the Viability of Bowel

Herrlin, John O.; Glasser, S.Thomas; Lange, Kurt

doi:10.1001/archsurg.1942.01220050096008

Cited by 30 publications

(7 citation statements)

References 2 publications

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“…The first use of fluorescein, an organic dye, to improve the assessment of ischemic bowel was reported by Herrlin et al [6] in 1942. As its name suggest, it has a green fluorescence maximal at the ultraviolet wavelength of 3600 AO and appears readily in extracellular fluid and viable cells when given intravenously.…”

Section: Discussionmentioning

confidence: 99%

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Necrotizing enterocolitis: Early conventional and fluorescein laparoscopic assessment

Numanoglu

Millar

2011

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

“…Fluorescein assessment of ischemic bowel has been used since 1942 [6] but has been largely limited to adult patients with superior mesenteric artery occlusion. Recently, fluorescein laparoscopy to identify ischemic bowel has been used successfully in experimental animal studies [7].…”

mentioning

confidence: 99%

Necrotizing enterocolitis: Early conventional and fluorescein laparoscopic assessment

Numanoglu

Millar

2011

Journal of Pediatric Surgery

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“…[5,6] It has also been used to assess the viability of ischemic bowel in experimental models and in clinical practice. [7] The standard technique describes the use of a Wood's lamp to visualize the tissue fluorescence. The result is then photographed using two color filters ) .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the vascularity of an isolated bowel segment using fluorescein angiography in rats

Chandrasekharam

Talwar

Bhatnagar

2007

J Indian Assoc Pediatr Surg

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Aims: An isolated bowel segment (IBS), a viable loop of bowel completely free of its mesenteric attachments, has potential clinical use in bowel lengthening and other techniques. The end point of successful creation of an IBS is the development of adequate collateral circulation. In this experimental study, we report the use of fluorescein test to demonstrate collateral vascularity of the IBS in rats. A simple technique for the visualization and photography of fluorescein in the tissues is also described. Materials and Methods: In nine Wistar rats, 5 cm of distal ileum was anastomosed side-to-side to 5 cm of proximal colon using 6/0 PDS. In one rat (control), the colon patch was isolated from the rest of the large bowel immediately and fluorescein test was performed. The remaining eight (study group) rats were operated after 8 weeks and the procedure followed as in the control rat. In the last rat, the mesentery of the colon patch was severed; and 2 weeks later, the fluorescein test was performed. Results: The colon patch in the control rat showed complete lack of fluorescence; in the seven rats tested after 8 weeks, patchy fluorescence was demonstrated in the colon patch; and in the last rat, bright fluorescence of the whole patch could be demonstrated within a few seconds following fluorescein injection. Conclusion: This study describes a simple technique for the fluorescein test. The observation that the vascular collaterals were more abundant after mesocolic division was obviously due to the opening up of collaterals over a period of time. The fluorescein test is a rapid and easy test and can be easily reproduced.

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“…Com relação à atividade peristáltica, esta cessa nos estados isquêmicos, retornando quando há revascularização de alças ainda viáveis. Apesar disso, está comprovado que o peristaltismo não é uma medida segura da viabilidade intestinal 37 , uma vez que em comprometimentos vasculares irreversíveis a atividade peristáltica se mantém sob a forma de espasmo anóxico, sendo esse facilmente confundido com peristaltismo normal 39,61,71 .…”

Section: Avaliação Por Critérios Clínicosunclassified

Avaliação perioperatória da viabilidade intestinal

Esteves

Caravatto

Yamakami

et al. 2003

Rev. Med. (São Paulo)

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A determinação da viabilidade de segmentos intestinais e do grau de isquemia a partir de critérios clínicos pode ser de extrema dificuldade para o cirurgião. Faz-se necessário lançar mão de métodos auxiliares para se atestar o grau de comprometimento da alça intestinal, muitas vezes inaparenteà avaliação clínica. O presente trabalho apresenta uma revisão de literatura dos principais métodos existentes para se fazer essa avaliação, descrevendo a técnica e equipamentos necessários para cada um, bem como os resultados da aplicação dos mesmos. Os principais métodos auxiliares encontrados na literatura se dividem em experimentais: eletromiografia, laser Doppler sem contato e Imagem térmica; e clínicos: avaliação exclusiva por critérios clínicos, Doppler ultrassom, laser Doppler, injeção intravascular de corantes, oximetria superficial, oximetria de pulso, termometria, pHmetria, tonometria e fotopletismografia infravermelha. São também reinterados os resultados da indicação e realização das relaparotomias no manejo de pacientes com insuficiência vascular mesentérica. Após a revisão de literatura, pudemos concluir que o Doppler ultrassom e a injeção intravenosa de fluoresceína representam os métodos auxiliares para a avaliação perioperatória da viabilidade intestinal mais utilizados devidoprincipalmente ao seu baixo custo e relativa facilidade de uso. Optamos por destacar o papel da laparoscopia pós-operatória no segmento de pacientes submetidos ao tratamento cirúrgico de insuficiência vascular mesentérica, em especial naqueles em que a avaliação da viabilidade intestinal foi duvidosa.

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New Methods for Determining the Viability of Bowel

Cited by 30 publications

References 2 publications

Necrotizing enterocolitis: Early conventional and fluorescein laparoscopic assessment

Necrotizing enterocolitis: Early conventional and fluorescein laparoscopic assessment

Evaluation of the vascularity of an isolated bowel segment using fluorescein angiography in rats

Avaliação perioperatória da viabilidade intestinal

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