Purpose: Fatal ischemic colitis can develop after abdominal aortic aneurysmectomy. We investigated the effectiveness of transanal laser Doppler flowmetry (LDF) for assessing microcirculation in the rectal mucosa during aneurysm repair.
Methods: The subjects were 17 patients who underwent abdominal aortic aneurysmectomy. A Doppler laser and Doppler probe were mounted on a rectoscope, which was inserted into the anus, and rectal flux values were obtained by a flowmeter.
Results: The mean flux value during aortic clamping was 146 +/- 35.6 perfusion units (PU) in patients with sufficient collateral circulation to the upper rectum and 58.3 +/- 19.4 PU in patients with insufficient collateral circulation ( P << 0.01). The LDF values and inferior mesenteric artery stump pressure measurements were well correlated ( r = 0.86).
Conclusion: Transanal rectal LDF is useful for continuously assessing microcirculation in the rectal mucosa during abdominal aneurysmectomy, and the data obtained with this method may reflect whether a collateral pathway to the upper rectum exists.