Prediction of anastomotic leakage after left-sided colorectal cancer surgery: a pilot study utilizing quantitative near-infrared spectroscopy.

Background: Anastomotic leakage (AL) occurs with some frequency in all types of colorectal cancer surgery and is associated with increased morbidity, mortality and recurrence rates. Complications might be prevented by monitoring intra-operative bowel perfusion at the anastomotic site. A pilot study concerning the objective and quantitative measurement of tissue perfusion by monitoring regional tissue saturation of oxygen (rSO ₂ ) was conducted, using the In Vivo Optical Spectroscopy (INVOS™) system (Medtronic, Minneapolis, MN, USA).
Methods: This study evaluated the ability of the INVOS™ system to predict AL after left-sided colorectal cancer surgery. rSO ₂ measurements of the oral side of the site of bowel anastomosis were taken before anastomosis in 73 patients. Clinical factors, including rSO ₂ , were analyzed to identify risk factors for AL.
Results: Among 73 patients, 6 (8.2%) experienced AL. The rSO ₂ values of the oral anastomotic site were significantly lower in AL patients than in non-AL patients. In the multivariate analysis, the rSO ₂ value of the oral anastomotic site was an independent risk factor for AL.
Conclusion: Monitoring the rSO ₂ at the anastomotic site enabled the prediction of AL. A prospective study to evaluate the efficacy of the INVOS™ system for monitoring intestinal rSO ₂ is in progress.
(© 2021. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.)