title: Intraoperative assessment of microperfusion with visible light spectroscopy for prediction of anastomotic leakage in colorectal anastomoses.
abstract: OBJECTIVE
  Anastomotic leakage is associated with increased morbidity and mortality. However, there is no accurate tool to predict its occurrence. We evaluated the predictive value of visible light spectroscopy (VLS), a novel method to measure tissue oxygenation [saturated O(2) (StO(2) )], for anastomotic leakage of the colon and the rectum.
  
  
  METHODS
  Oxygen saturation in the bowel was measured in 77 colorectal resections. The anastomosis was between 2 and 30 cm (mean 13 cm) from the anal verge. The oxygen saturation was measured in the colon and rectum before and after anastomosis construction. This was compared with a reference measurement in the caecum. Data on postoperative complications were prospectively collected.
  
  
  RESULTS
  Anastomotic leakage occurred in 14 (18%) patients. When compared with a leaking anastomosis, normal anastomoses showed rising O(2) values during the operation (mean StO(2) 72.1 ± 9.0-76.7 ± 8.0 vs 73.9 ± 7.9-73.1 ± 7.4) (P ≤ 0.05). There were also higher StO(2) values in the caecum compared with those which ultimately leaked (73.6 ± 5.7 normal anastomoses, 69.6 ± 5.6 anastomotic leaks) (P ≤ 0.05). Both StO(2) values were predictive of anastomotic leakage.
  
  
  CONCLUSIONS
  Tissue oxygenation O(2) appears to be a potentially useful means of predicting anastomotic leakage after colorectal anastomosis.
authors.affiliation: Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands. anne.karliczek@helsebergen.com
authors.forename: A
authors.initials: A
authors.lastname: Karliczek
authors.forename: D A
authors.initials: DA
authors.lastname: Benaron
authors.forename: P C
authors.initials: PC
authors.lastname: Baas
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: T
authors.initials: T
authors.lastname: Wiggers
authors.forename: G M
authors.initials: GM
authors.lastname: van Dam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000175:diagnosis*; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis*; D008027:Light; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010092:Oximetry; D012002:Rectal Diseases / Q000601:surgery*