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International Journal of Colorectal Disease

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01-03-2018 | Short Communication

Intraoperative colonic pulse oximetry in left-sided colorectal surgery: can it predict anastomotic leak?

Authors: Johannes M. Salusjärvi, Monika A. Carpelan-Holmström, Johanna M. Louhimo, Olli Kruuna, Tom M. Scheinin

Published in: International Journal of Colorectal Disease | Issue 3/2018

Abstract

Background

An anastomotic leak is a fairly common and a potentially lethal complication in colorectal surgery. Objective methods to assess the viability and blood circulation of the anastomosis could help in preventing leaks. Intraoperative pulse oximetry is a cheap, easy to use, fast, and readily available method to assess tissue viability. Our aim was to study whether intraoperative pulse oximetry can predict the development of an anastomotic leak.

Methods

The study was a prospective single-arm study conducted between the years 2005 and 2011 in Helsinki University Hospital. Patient material consisted of 422 patients undergoing elective left-sided colorectal surgery. The patients were operated by one of the three surgeons. All of the operations were partial or total resections of the left side of the colon with a colorectal anastomosis. The intraoperative colonic oxygen saturation was measured with pulse oximetry from the colonic wall, and the values were analyzed with respect to post-operative complications.

Results

2.3 times more operated anastomotic leaks occurred when the colonic StO₂ was ≤ 90% (11/129 vs 11/293). The mean colonic StO₂ was 91.1 in patients who developed an operated anastomotic leak and 93.0 in patients who did not. With logistic regression analysis, the risk of operated anastomotic leak was 4.2 times higher with StO₂ values ≤ 90%.

Conclusions

Low intraoperative colonic StO₂ values are associated with the occurrence of anastomotic leak. Despite its handicaps, the method seems to be useful in assessing anastomotic viability.

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Title: Intraoperative colonic pulse oximetry in left-sided colorectal surgery: can it predict anastomotic leak?
Authors: Johannes M. Salusjärvi
Monika A. Carpelan-Holmström
Johanna M. Louhimo
Olli Kruuna
Tom M. Scheinin
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 3/2018
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-018-2963-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intraoperative colonic pulse oximetry in left-sided colorectal surgery: can it predict anastomotic leak?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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