Assessment of Anastomotic Viability With Spectroscopic Real-time Oxygen Saturation Measurement in a Porcine Study.

Autor: Khosrawipour T; Division of Colorectal Surgery, Department of Surgery, University of California Irvine, Orange, CA, USA.; Department of Surgery (A), University-Hospital Duesseldorf, Heinrich-Heine University Duesseldorf, Germany., Li S; Division of Colorectal Surgery, Department of Surgery, University of California Irvine, Orange, CA, USA.; Division of Colon and Rectal Surgery, Department of Surgery, New York Presbyterian Hospital- Weill Cornell College of Medicine, New York, NY, USA., Steward E; Division of Colorectal Surgery, Department of Surgery, University of California Irvine, Orange, CA, USA., Chaudhry H; Division of Colorectal Surgery, Department of Surgery, University of California Irvine, Orange, CA, USA., Nguyen D; Division of Colorectal Surgery, Department of Surgery, University of California Irvine, Orange, CA, USA., Khosrawipour V; Division of Colorectal Surgery, Department of Surgery, University of California Irvine, Orange, CA, USA., Jafari MD; Division of Colorectal Surgery, Department of Surgery, University of California Irvine, Orange, CA, USA., Pigazzi A; Division of Colorectal Surgery, Department of Surgery, University of California Irvine, Orange, CA, USA.; Division of Colon and Rectal Surgery, Department of Surgery, New York Presbyterian Hospital- Weill Cornell College of Medicine, New York, NY, USA.
Jazyk: angličtina
Zdroj: Surgical innovation [Surg Innov] 2023 Jun; Vol. 30 (3), pp. 349-355. Date of Electronic Publication: 2022 Oct 18.
DOI: 10.1177/15533506221127378
Abstrakt: Objective: Anastomotic leakage (AL) is a severe complication following intestinal procedures. Intra.Ox™ by ViOptix Inc (Newark, CA, USA) is a novel, FDA-approved spectroscopic device which enables real-time measurement of mixed tissue oxygen saturation (StO 2 ). Using a porcine model, this study explores the correlation between StO 2 measurements and AL formation as well as investigates the applicability of Intra.Ox™ in the clinical setting.
Methods: Eleven female swine were divided into 3 groups to explore AL formation in different ischemic conditions. Group 1: 100% mesenteric-vascular ligation, n = 3; Group 2: 50% ligation, n = 5; Group 3: No mesenteric ligation, n = 3. StO 2 at the anastomotic line was measured before and after vessel ligation and anastomosis. Measurements were taken at 6 distinct locations along afferent and efferent loops. AL was evaluated on postoperative day 5 by re-laparotomy.
Results: AL rate was 100%, 60% and 0% in groups 1, 2 and 3, respectively. Post-anastomotic StO 2 in group 1 (22.9 ± 18.5%) and 2 (39.2 ± 20.1%) were significantly lower than in group 3 (53.1 ± 8.3%, p<.0001). Post-anastomotic StO 2 readings ≤40% indicated AL potential with 100% sensitivity,+ 80% specificity, positive predictive value of 85.7% and negative predictive value of 100%.
Conclusion: This study demonstrates the value of Intra.Ox™ in assessing local perfusion and indicate the association between low StO 2 and AL by providing accurate, real-time, noninvasive tissue oxygenation measurements at anastomotic sites. Further studies are required to investigate the clinical application of this novel device in intestinal surgery.
Databáze: MEDLINE
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