AI Article Synopsis
- An anastomotic leak is a serious complication in colorectal surgery, and assessing tissue viability is crucial for preventing it.
- A study conducted at Helsinki University Hospital from 2005 to 2011 analyzed 422 patients undergoing left-sided colorectal surgery, measuring colonic oxygen saturation using pulse oximetry.
- The findings indicated that patients with colonic oxygen saturation levels (StO) ≤ 90% were significantly more likely to experience anastomotic leaks, highlighting the importance of monitoring these levels during surgery.
Article Abstract
Background: An anastomotic leak is a fairly common and a potentially lethal complication in colorectal surgery. Objective methods to assess the viability and blood circulation of the anastomosis could help in preventing leaks. Intraoperative pulse oximetry is a cheap, easy to use, fast, and readily available method to assess tissue viability. Our aim was to study whether intraoperative pulse oximetry can predict the development of an anastomotic leak.
Methods: The study was a prospective single-arm study conducted between the years 2005 and 2011 in Helsinki University Hospital. Patient material consisted of 422 patients undergoing elective left-sided colorectal surgery. The patients were operated by one of the three surgeons. All of the operations were partial or total resections of the left side of the colon with a colorectal anastomosis. The intraoperative colonic oxygen saturation was measured with pulse oximetry from the colonic wall, and the values were analyzed with respect to post-operative complications.
Results: 2.3 times more operated anastomotic leaks occurred when the colonic StO was ≤ 90% (11/129 vs 11/293). The mean colonic StO was 91.1 in patients who developed an operated anastomotic leak and 93.0 in patients who did not. With logistic regression analysis, the risk of operated anastomotic leak was 4.2 times higher with StO values ≤ 90%.
Conclusions: Low intraoperative colonic StO values are associated with the occurrence of anastomotic leak. Despite its handicaps, the method seems to be useful in assessing anastomotic viability.
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| http://dx.doi.org/10.1007/s00384-018-2963-4 | DOI Listing |
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