Literature DB >> 16115494

Intraoperative determination of intestinal viability: a comparison with transserosal pulse oximetry and histopathological examination.

Mehmet Erikoglu1, Adnan Kaynak, Ertan Abbas Beyatli, Hatice Toy.   

Abstract

BACKGROUND: In this study, we aimed to measure the O2 saturation of ischemic intestinal segments and the relationship between these measures and concomitant pathological gradings.
MATERIALS AND METHODS: We used 14 New Zealand White rabbits, anesthetized with a combination of 80 mg/kg (i.m.) Ketamine hydrochloride and 10 mg/kg Acepromazine (i.m.). The superior mesenteric artery (SMA) was explored, and O2 saturation was measured by pulse oximetry 5 cm proximal to the ileocecal valve at the 0th hour. At the same time a 0.5-cm full-thickness wedge biopsy was taken from the same region. Thereafter, the SMA was ligated and the abdomen was closed. All rabbits were undertaken relaparotomy at the 4th hour; O2 saturation was measured by pulse oximetry at 5 cm away from the region of the first biopsy and a 0.5-cm full-thickness wedge biopsy was taken. The abdomen was then closed. The same procedure was performed at the 8th and the 12th hour. Mucosal hemorrhage, transmural congestion, mucosal necrosis, and transmural necrosis were examined in the specimens.
RESULTS: Pathologically, transmural necrosis was concomitant with 64% O2 saturation (sensitivity: 100%; specificity: 86%). Mucosal necrosis was concomitant with 76% O2 saturation values (sensitivity: 100%; specificity: 75%). Transmural congestion was concomitant with 81% O2 saturation values (sensitivity: 89%; specificity: 58%). Mucosal hemorrhage was concomitant with 91% O2 saturation (sensitivity: 100%; specificity: 31%).
CONCLUSION: O2 saturation measures > 76% may indicate reversible changes as mucosal necrosis, transmural congestion, or mucosal hemorrhage, and O2 saturation measures < 64% may indicate permanent transmural necrosis. As a result, intraoperative evaluation of intestinal viability by pulse oximetry may give us an idea about the degree of pathological changes and subsequently might reduce the number of second-look operations.

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Year:  2005        PMID: 16115494     DOI: 10.1016/j.jss.2005.02.007

Source DB:  PubMed          Journal:  J Surg Res        ISSN: 0022-4804            Impact factor:   2.192


  5 in total

Review 1.  Acute mesenteric ischemia after cardio-pulmonary bypass surgery.

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Journal:  World J Gastroenterol       Date:  2008-09-21       Impact factor: 5.742

2.  Use of a silicone patch in the management of severe ischemic small bowel volvulus.

Authors:  Agnes Dahl-Farhoumand; J Birraux; A Darani; B E Wildhaber
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3.  How to assess intestinal viability during surgery: A review of techniques.

Authors:  Linas Urbanavičius; Piet Pattyn; Dirk Van de Putte; Donatas Venskutonis
Journal:  World J Gastrointest Surg       Date:  2011-05-27

4.  A low-cost reader for automatically collecting vital signs in hospitals.

Authors:  Kuo-Yi Chen; Fuh-Gwo Chen; Ting-Wei Hou
Journal:  J Med Syst       Date:  2011-05-24       Impact factor: 4.460

5.  Full-thickness small intestine necrosis with midgut volvulus, distributed in a patchy fashion, is reversible with moderate blood flow: resumption of normal function to non-viable intestine.

Authors:  Hizuru Amano; Hiroo Uchida; Hiroshi Kawashima; Yujiro Tanaka; Hiroshi Kishimoto
Journal:  Nagoya J Med Sci       Date:  2014-08       Impact factor: 1.131

  5 in total

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