Abstract
BackgroundEstablishing anastomotic integrity is crucial for avoiding anastomotic complications in colorectal surgery. This study aimed to evaluate the safety and feasibility of assessing anastomotic integrity using novel oxygen saturation imaging endoscopy in a porcine ischemia model.MethodsIn three pigs, a new endoscope system was used to check the mechanical completeness of the anastomosis and capture the tissue oxygen saturation (StO2) images. This technology can derive the StO2 images from the differences in the absorption coefficient in the visible light region between oxy- and deoxy-hemoglobin. Bowel perfusion at the proximal rectum was assessed before and after the anastomosis, and 1 min and 30 min after the ligation of the cranial rectal artery (CRA).ResultsThe completeness of the anastomoses was confirmed by the absence of air leakage. Intraluminal oxygen saturation imaging was successfully performed in all animals. There was no significant difference in the StO2 level before and after the anastomosis (52.6 ± 2.0 vs. 52.0 ± 2.6; p = 0.76, respectively). The StO2 level of the intestine on the oral side of the anastomosis one minute after the CRA ligation was significantly lower than immediately after the anastomosis (15.9 ± 6.0 vs. 52.0 ± 2.6; p = 0.006, respectively). There was no significant difference in the StO2 level between 1 min after and 30 min after the CRA ligation (15.9 ± 6.0 vs. 12.1 ± 5.3; p = 0.41, respectively).ConclusionNovel oxygen saturation imaging endoscopy was safe and feasible to assess the anastomotic integrity in the experimental model.
Highlights
Establishing anastomotic integrity is crucial for avoiding anastomotic complications in colorectal surgery
Macroscopic intraluminal assessment of anastomotic completeness using an intraoperative colonoscopy and the air leakage test have been broadly used to check the incompleteness of the anastomosis during surgery [6,7,8,9]
The aim of the current study was to evaluate the feasibility of assessing the anastomotic integrity using a novel oxygen saturation imaging endoscopy in a porcine ischemia model
Summary
Establishing anastomotic integrity is crucial for avoiding anastomotic complications in colorectal surgery. Despite advances in surgical techniques and medical devices, anastomotic leakage and stricture remain one of the most dreaded complications in colorectal surgery Anastomotic complications, such as postoperative morbidity and mortality, have a negative impact on short-term outcomes [1, 2]. Macroscopic intraluminal assessment of anastomotic completeness using an intraoperative colonoscopy and the air leakage test have been broadly used to check the incompleteness of the anastomosis during surgery [6,7,8,9] It is a vital procedure for avoiding anastomotic leakage to Hasegawa et al BMC Surg (2020) 20:250 evaluate whether blood supply to the anastomotic site is sufficient [5, 10]. There are negative aspects such as the necessity of administering the fluorescent substance, possibility of ICG allergy, and the surgeons’ qualitative assessment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
