Objective Identification of Severe Mesenteric Traction Syndrome Using Laser Speckle Contrast Imaging and Digital Thermography

Abstract

Introduction: Mesenteric Traction Syndrome (MTS) is defined as the occurrence of hypotension, tachycardia, and facial flushing early during abdominal surgery. MTS is divided into three levels: no, moderate, and severe MTS using the degree of facial flushing. During open abdominal surgery, approximately 35 % develop severe MTS, which is associated with significantly increased postoperative morbidity. Today, MTS is graded by subjective assessment of facial flushing. However, this method has its inherent limitations. Two possible methods for objective assessment of MTS are Laser Speckle Contrast Imaging (LSCI) and thermography. LSCI has been shown to distinguish severe MTS from moderate/no MTS, while thermography is known to correlate with LSCI. This study aimed at validating our predefined LSCI cut-off value and examining whether thermography could also identify severe MTS. Methods: Sixty patients undergoing open esophagectomy or Whipple procedure are planned for inclusion. Continuous LSCI and thermography assessment of the facial skin blood flow was performed, and the severity of MTS determined by our cut-off value. Blood samples and hemodynamics were sampled at predefined times to validate our cut-off value and assess their correlation to LSCI and thermography. Results: Forty-seven patients have been included, and inclusion will be finished by May 2022. Preliminary analysis showed significant differences in hemodynamics between patients with severe MTS and patients with moderate/no MTS by LSCI. Further, LSCI and thermography correlated significantly with significantly higher facial temperatures in patients with severe MTS. Conclusion: This study shows that both LSCI and thermography can successfully distinguish severe MTS from moderate/no MTS.