[Methods for colon perfusion assessment]

Colorectal cancer is a malignant tumor arising from mucosa of large intestine (colon, rectosigmoid part and rectum). Currently, surgery is the primary treatment for colorectal cancer regarding oncological perspective. However, it is associated with high risk of postoperative complications, and one of these is anastomotic leakage (AL). According to various data, the incidence of AL can reach 35%. One of the main factors for AL is impairment of perfusion in anastomotic area. We hypothesize that preserving the left colic artery in rectosigmoid and rectal surgeries, as well as the first sigmoid artery in rectal surgeries will reduce the incidence of AL. Modern technologies, including CT perfusion, indocyanine green dye, photoplethysmography, perfusion flowmetry, and MASP (marginal artery stump pressure) allow us to assess perfusion preoperatively and intraoperatively. This review analyzes the main causes of AL from physiological and metabolic-biochemical perspective. It presents statistical data reflecting the relevance of intestinal perfusion assessment and proposes hypotheses that could significantly reduce the incidence of anastomotic leakage. Study objective was to select the optimal method for assessing intestinal perfusion. We analyzed the articles published in PubMed and Sci-Hub databases.