Tissue oxygen saturation during colorectal surgery measured by near-infrared spectroscopy: pilot study to predict anastomotic complications.
BACKGROUND
We investigated the relation between tissue oxygen saturation measured by near-infrared spectroscopy (NIRS) and anastomotic complications associated with colorectal surgery.


METHODS
A series of 20 patients with colorectal cancer underwent radical surgery with enteric anastomosis. Measurements of tissue oxygen saturation (StO2) were performed at both the proximal and distal portions of the anastomotic site; in cases of anterior resection, we measured StO2 only in the proximal portion.


RESULTS
Two anastomotic complications (one leakage, one stenosis) occurred in the 20 cases. The StO2 in patients with anastomotic complications was 58.0%, and that in patients without complications was 71.0%. Altogether, 18 patients had StO2 values > 66%, and none of them had anastomotic complications. In contrast, 2 patients had StO2 values < 60%, and both had anastomotic complications.


CONCLUSIONS
The StO2 of the anastomotic site can be safely and reliably measured by NIRS during colorectal surgery. Low StO2 on both sides of the anastomosis may indicate an increased risk of anastomotic complications. Further study is needed to determine the cutoff value for StO2 required to prevent serious complications.
Hirano
Yasumitsu
Y
Department of Surgery, Saiseikai Kanazawa Hospital, Ni-13-6 Akatsuchi-machi, Kanazawa, 920-0353, Japan.
Omura
Kenji
K
Tatsuzawa
Yasuhiko
Y
Shimizu
Junzo
J
Kawaura
Yukimitsu
Y
Watanabe
Go
G
D000368:Aged; D000714:Anastomosis, Surgical; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D019265:Spectroscopy, Near-Infrared
D010100:Oxygen