PURPOSE: Both "high tie" (HT) and "low tie" (LT) are well-known strategies in rectal surgery. The aim of this study was to compare colonic perfusion after HT to colonic perfusion after LT. METHODS: Patients undergoing rectal resection for malignancy were included. Colonic perfusion was measured with laser Doppler flowmetry, immediately after laparotomy on the antimesenterial side of the colon segment that was to become the afferent loop (measurement A). This measurement was repeated after rectal resection (measurement B). The blood flow ratios (B/A) were compared between the HT group and the LT group. RESULTS: Blood flow was measured in 33 patients, 16 undergoing HT and 17 undergoing LT. Colonic blood flow slightly decreased in the HT group whereas the flow increased in the LT group. The blood flow ratio was significantly higher in the LT group (1.48 vs. 0.91; p = 0.04), independent of the blood pressure. CONCLUSION: This study shows the blood flow ratio to be higher in the LT group. This suggests that anastomoses may benefit from better perfusion when LT is performed.
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机译：目的：“高领带”（HT）和“低领带”（LT）都是直肠手术中众所周知的策略。这项研究的目的是比较HT后的结肠灌注与LT后的结肠灌注。方法：包括因恶性肿瘤而接受直肠切除的患者。开腹手术后立即在即将成为传入回路的结肠段的前肠侧，用激光多普勒血流仪测量结肠的灌注（测量A）。直肠切除后重复此测量（测量B）。比较HT组和LT组的血流比（B / A）。结果：测量了33例患者的血流量，其中16例进行了HT，17例进行了LT。 HT组结肠血流略有减少，而LT组结肠血流增加。 LT组的血流比率显着较高（1.48对0.91; p = 0.04），与血压无关。结论：这项研究表明LT组的血流比率更高。这表明当进行LT时，吻合可能会受益于更好的灌注。
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