Article ID: 15-3
Non-occlusive mesenteric ischemia （NOMI） is a disease that results in impaired intestinal blood flow without organic obstruction of the main trunk of mesenteric vessels. Despite improvements in diagnosis and surgical treatment, it remains an emergency condition with a high mortality rate. At our hospital, before 2021, the physician in charge individually decided the treatment plan and surgical procedure for NOMI, but after 2022, indocyanine green （ICG） fluorescence angiography, open abdominal management （OAM）, and second-look operation were standardized in all cases. With this strategy, after naked eye confirmation of an abnormal color of the intestinal tract, blood flow is evaluated using ICG fluorescence angiography, and the extent of resection is determined. A second-look operation is performed within 48 hours after OAM without anastomosis, during which ICG fluorescence angiography is also performed. These procedures support the surgeon in determining the extent of the resection required, and reduce the surgeon's mental stress. We would like to continue further studies to improve surgical outcomes and the prognosis of NOMI by accumulating cases in which these strategies are used.
