LAPAROTOMY AFTER USING THE GASTROEPIPLOIC ARTERY GRAFT - RETROGASTRIC VERSUS ANTEGASTRIC ROUTE

被引:14
作者
DIETL, CA
DEITRICK, JE
WEST, JC
PAGANA, TJ
机构
[1] GEISINGER MED CTR,DEPT GEN SURG,DANVILLE,PA 17822
[2] WILLIAMSPORT HOSP,DEPT SURG,WILLIAMSPORT,PA
关键词
D O I
10.1016/0003-4975(95)00412-E
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Most cardiac surgeons prefer the antegastric route for the right gastroepiploic artery (RGEA) graft. When placed anterior to the stomach, the RGEA pedicle may adhere to the greater omentum, or to the anterior abdominal wall, and may be injured during future abdominal operations. Methods. To avoid this potentially lethal complication, we prefer to place the RGEA graft behind the stomach and the left lobe of the liver. In our exl,erience with 144 patients in whom the retrogastric route was used, 7 patients required an abdominal operation (2 had cholecystectomy, 2 had a partial colectomy, 1 had repair of paraesophageal hernia, and 2 had repair of abdominal wall complications). There was no need to dissect the RGEA graft in any of these patients. Results. There was no evidence of myocardial ischemia or other complications during or after the operation in any patient. Conclusions. Based on our experience and the fact that any injury to the RGEA graft may have catastrophic consequences, we strongly advocate the retrogastric route to minimize the risk of injury to the RGEA graft during a subsequent laparotomy.
引用
收藏
页码:382 / 385
页数:4
相关论文
共 18 条
[1]   THE USE OF THE RIGHT GASTRO-EPIPLOIC ARTERY IN CORONARY-ARTERY BYPASS-GRAFTING [J].
CARTER, MJ .
AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY, 1987, 57 (05) :317-321
[2]  
DIETL CA, 1995, J CARDIOVASC SURG, V36, P39
[3]  
DIETL CA, IN PRESS CIRCULATION
[4]   ARTERIAL REVASCULARIZATION WITH THE RIGHT GASTROEPIPLOIC ARTERY AND INTERNAL MAMMARY ARTERIES IN 300 PATIENTS [J].
GRANDJEAN, JG ;
BOONSTRA, PW ;
DENHEYER, P ;
EBELS, T ;
KIRKLIN, JW .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1994, 107 (05) :1309-1316
[5]   USE OF THE RIGHT GASTROEPIPLOIC ARTERY AS A PEDICLED ARTERIAL GRAFT FOR CORONARY REVASCULARIZATION [J].
ISOMURA, T ;
HISATOMI, K ;
HIRANO, A ;
HAYASHIDA, N ;
OHISHI, K .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 1993, 7 (01) :38-41
[6]   IS ELECTROCAUTERY SAFE FOR INTERNAL MAMMARY ARTERY (IMA) MOBILIZATION - A STUDY USING SCANNING ELECTRON-MICROSCOPY (SEM) [J].
LEHTOLA, A ;
VERKKALA, K ;
JARVINEN, A .
THORACIC AND CARDIOVASCULAR SURGEON, 1989, 37 (01) :55-57
[7]  
LYTLE BW, 1989, J THORAC CARDIOV SUR, V97, P826
[8]   RIGHT GASTROEPIPLOIC ARTERY USED FOR CORONARY-ARTERY BYPASS-GRAFTING - EVALUATION OF FLOW CHARACTERISTICS AND SIZE [J].
MILLS, NL ;
HOCKMUTH, DR ;
EVERSON, CT ;
ROBART, CC .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1993, 106 (04) :579-586
[9]   RIGHT GASTROEPIPLOIC ARTERY - A 3RD ARTERIAL CONDUIT FOR CORONARY-ARTERY BYPASS [J].
MILLS, NL ;
EVERSON, CT .
ANNALS OF THORACIC SURGERY, 1989, 47 (05) :706-711
[10]   CLINICAL-EXPERIENCE WITH THE RIGHT GASTROEPIPLOIC ARTERY IN CORONARY-ARTERY BYPASS-GRAFTING [J].
PERRAULT, LP ;
CARRIER, M ;
HEBERT, Y ;
HUDON, G ;
CARTIER, R ;
LECLERC, Y ;
PELLETIER, LC .
ANNALS OF THORACIC SURGERY, 1993, 56 (05) :1082-1084