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01-11-2017 | Original Scientific Report

Colon Perfusion Patterns During Colorectal Resection Using Visible Light Spectroscopy

Authors: Henry Hoffmann, Tarik Delko, Philipp Kirchhoff, Rachel Rosenthal, Juliane Schäfer, Marko Kraljević, Christoph Kettelhack

Published in: World Journal of Surgery | Issue 11/2017

Abstract

Background

The impact of blood supply to the anastomosis on development of anastomotic leakage is still a matter of debate. Considering that bowel perfusion may be affected by manipulation during surgery, perfusion assessment of the anastomosis alone may be of limited value. We propose perfusion assessment at different time points during surgery to explore the dynamics of bowel perfusion during colorectal resection and its impact on outcome.

Methods

In this prospective cohort study, patients undergoing elective colorectal resection were eligible. Colon perfusion was evaluated using visible light spectroscopy. Main outcome was the difference in colon perfusion, quantified by measuring tissue oxygen saturation (StO₂) in the colonic serosa, before and after anastomosis during surgery.

Results

We included 58 patients between July 2013 and November 2015. Colon perfusion increased by an average of 5.9% StO₂ during surgery (95% confidence interval 3.1, 8.8; P < 0.001). The number of patients with abnormal perfusion (defined as StO₂ < 65%) decreased from 50% at the beginning to 24% by the end of surgery. Six patients (10%) developed anastomotic leaks (AL), of which five patients had abnormal perfusion at the beginning of surgery, whereas four patients had normal StO₂ at the anastomosis.

Conclusion

Colon perfusion significantly increased during colorectal surgery. Considering that one quarter of patients had suboptimal anastomotic perfusion without developing AL, impaired blood flow at the anastomosis alone does not seem to be critical. Further investigations including more patients are necessary to evaluate the impact of perioperative parameters on colon perfusion, anastomotic healing and surgical outcome.

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Title: Colon Perfusion Patterns During Colorectal Resection Using Visible Light Spectroscopy
Authors: Henry Hoffmann
Tarik Delko
Philipp Kirchhoff
Rachel Rosenthal
Juliane Schäfer
Marko Kraljević
Christoph Kettelhack
Publication date: 01-11-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 11/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4100-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Colon Perfusion Patterns During Colorectal Resection Using Visible Light Spectroscopy

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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