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[Methods for colon perfusion assessment].

T S Lankov1, A N Lavrenteva2, A M Karachun3

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Preserving specific arteries during colorectal cancer surgery may reduce the risk of anastomotic leakage (AL), a serious complication. Assessing intestinal perfusion is key to preventing AL and improving patient outcomes.

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Vascular Surgery

Background:

  • Colorectal cancer surgery is primary treatment but risks postoperative complications like anastomotic leakage (AL).
  • Anastomotic leakage (AL) incidence can reach 35%, often due to impaired perfusion in the anastomotic area.
  • Understanding the physiological and metabolic causes of AL is crucial for improving surgical outcomes.

Purpose of the Study:

  • To analyze the causes of anastomotic leakage (AL) in colorectal surgery.
  • To evaluate the relevance of intestinal perfusion assessment in preventing AL.
  • To propose hypotheses and select optimal methods for assessing intestinal perfusion to reduce AL incidence.

Main Methods:

  • Literature review of articles from PubMed and Sci-Hub databases.
  • Analysis of physiological and metabolic-biochemical causes of AL.
  • Evaluation of modern technologies for perfusion assessment: CT perfusion, indocyanine green dye, photoplethysmography, perfusion flowmetry, and marginal artery stump pressure (MASP).

Main Results:

  • Impaired perfusion is a significant factor contributing to anastomotic leakage (AL).
  • Preserving the left colic artery and the first sigmoid artery may reduce AL incidence in specific rectal surgeries.
  • Various technologies can assess intestinal perfusion pre- and intraoperatively.

Conclusions:

  • Optimizing surgical techniques, such as artery preservation, can potentially decrease AL rates.
  • Accurate assessment of intestinal perfusion is vital for preventing anastomotic leakage.
  • Further research into optimal perfusion assessment methods is needed to reduce AL in colorectal surgery.