Aims: To evaluate the role of the endoscopic assisted second-look in patients with mesenteric vascular occlusion (MVO).
Methods: Between February 2016 and February 2017, 25 patients were operated for the treatment of MVO. For all patients resection of variable lengths of bowels was performed. In spite of the clinical course of the patients, the endoscopic assisted second-look examination was performed 72 hours postoperatively at the bed side in the ICU or in the operating room via a large nelaton rectal tube catheter which was put in the patients’ abdominal cavity to assist the drainage and to give an access to the peritoneal cavity postoperatively.
Results: The mean time of admission after the onset of symptoms was three days (range, 1–5 days). In all patients, laparotomy was performed and variable lengths of dead small bowel mean 2.25 meters (range 1–3 meters) were resected and anastomosis was done. In 18 patients, the endoscopic assisted second-look examination revealed normal bowel viability and apparently good anastomosis, In five patients, intestinal necrosis was detected and in two patients anastomotic leakage was detected. For those seven patients, a second operation was necessary for further resection of the necrotic part of bowel and to correct the anastomotic leakage respectively.
Conclusion: The endoscopic assisted second-look is a minimally invasive, simple approach that can be performed at the bed-side for diagnosing the progress of MVO. It also helps to decrease the need for unnecessary second laparotomy, however, Close clinical and laboratory observation of all patients, even those with negative second-look procedures cannot be omitted.