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Multimodality Diagnosis of Mesenteric Ischemia
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Dynamic Serosal Perfusion Assessment during Colorectal Resection Using Visible Light Spectroscopy.

Alexander Gräfitsch1,2, Philipp Kirchhoff1,3, Savas D Soysal1

  • 1General and Visceral Surgery, University Hospital Basel, Basel, Switzerland.

European Surgical Research. Europaische Chirurgische Forschung. Recherches Chirurgicales Europeennes
|April 27, 2021
PubMed
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Colorectal surgery patients showed increasing serosal oxygen saturation (StO2) during procedures. Anastomotic leakage was not linked to lower StO2, indicating complex causes for this complication.

Keywords:
Anastomotic leakageColonic perfusionColorectal surgerySpectroscopy

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Area of Science:

  • Colorectal Surgery
  • Surgical Physiology
  • Medical Devices

Background:

  • Anastomotic leakage (AL) is a significant complication in colorectal surgery, occurring in up to 20% of cases.
  • Bowel perfusion is a critical factor for anastomotic healing, but its intraoperative variability and impact remain understudied.

Purpose of the Study:

  • To evaluate serosal oxygen saturation (StO2) patterns during colorectal resections using visible light spectroscopy (VLS).
  • To investigate the relationship between intraoperative StO2 and anastomotic healing outcomes.

Main Methods:

  • Visible light spectroscopy (VLS) was used to assess colonic serosal oxygen saturation (StO2) at various surgical timepoints.
  • 50 patients undergoing left-sided colorectal resections for cancer or diverticular disease were included.

Main Results:

  • Serosal oxygen saturation (StO2) at the proximal anastomosis site significantly increased during surgery (mean difference 3.61%).
  • Deviations from the observed perfusion pattern did not correlate with postoperative outcomes.
  • Anastomotic leakage (AL) was not associated with lower intraoperative StO2 levels.

Conclusions:

  • Colonic StO2 increases during colorectal resection surgery.
  • The multifactorial nature of anastomotic leakage (AL) is highlighted, as it is not solely dependent on intraoperative serosal oxygen saturation.