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KMID : 0383119750230010077
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Journal of Aerospace Medicine
1975 Volume.23 No. 1 p.77 ~ p.83
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Clinical Evaluation of the Extensive Resection of the Small Intestine
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Abstract
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Department of General Surgery, National police Hospital. Removal of a large part of the small intestine is not undertaken lightly because of the ill effects on nutrition which may ensue. Occasionally, however, such resections cannot be avoided when the surgeon is faced with severe extensive disease of the intestine.
The terms "massive" or "extensive" resection of small intestine generally implies removal of more than 200cm or one third of its total length. The minimal length of small intestine necessary for a tolerable life is a general view today that two thirds of the small intestine may be resected without untoward sequelae.
The purpose of this paper is to evaluate clinical status in a series of patients following massive resection of the small intestine. During the period from January, 1963 to July, 1970, thirteen underwent massive resection of the small intestine at the National Seoul University Hospital and National Police Hospital. The thirteen patients are divided into two groups according to the type of resection : Group I , partial resection of the jejunum and ileum : Group II, partial resection of the jejunum and ileum including cecum and ascending colon. Following such extensive resection several changes take place. The remaining got undergoes considerable hypertrophy-including the villi and the remaining part of small intestine elongates. The gastric secreation increases and emptying of the stomach becomes delayed.
The metabolic studies following extensive small intestine resection will always be an increased loss of fat, water, proteins and electrolytes in the feces. A few patients were developed hypocalemia and tetany. The most frequent cause of death were malnutrition and deaths usually occurs three to twelve months after operation.
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