Abstract

ABSTRACT Introduction: Anastomotic leak (AL) is the Achilles’ heel of colorectal surgery. Adequate perfusion of the bowel segments to be anastomosed is a prerequisite for healing. Traditionally surgeons have assessed bowel perfusion subjectively, and studies indicate that it is not sensitive in predicting anastomotic leak rates. Hence, a need for objective assessment of bowel perfusion was advocated and various techniques have been developed to assess bowel perfusion. The purpose of this review is to study the clinical application of intraoperative infrared thermography (IRT) in assessing bowel perfusion in colorectal surgery and its effect on the rate of AL. Methods: Literature search using keywords ‘colo-rectal surgery’ ‘bowel perfusion’, ‘anastomotic leak’, ‘infra-red thermography’ was done. All english language studies investigating role of infra-red thermography in assesing bowel perfusion were included in analysis. Results: Nine studies were found where bowel perfusion was assessed using IRT in humans as well as animals. These studies demonstrated that IRT is a sensitive and safe investigation and can be used as an adjunct in colorectal surgery. None of the studies were large enough to demonstrate a statistically significant effect on AL rates. Conclusion: IRT appears to be a feasible adjunct in colorectal surgery and appears to be a safe and sensitive method to assess bowel perfusion. Further randomized controlled trials with larger patient population are required to advocate its routine use in colorectal surgery.

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