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Intraoperative Measurement Of Colonic Oxygenation During Bowel Resection

  • Daya B. Singh
  • Gerard Stansby
  • Iain Bain
  • David K. Harrison
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 645)

Abstract

Recently lightguide spectrophotometry (LGS) has been investigated for assessing bowel mucosal oxygenation and may prove helpful in the diagnosis of bowel ischaemia. This pilot study explores the use of LGS and laser Doppler flowmetry (LDF)to measure SO2 and perfusion in the bowel during key stages of colon surgery. SO2 and perfusion in the mucosal and serosal layers of the rectum, sigmoid and descending colon were measured in 7 patients by LGS (Whitland Research, UK) and LDF (Moor Instruments, UK) respectively at four stages (baseline, after mobilisation of the sigmoid, after ligation of the inferior mesenteric artery (IMA) and after complete devascularisation of the sigmoid). The sigmoid mucosal SO2 and LDF values were significantly lower than the baseline after the ligation of IMA and devascularisation. Mean (SD) baseline sigmoid mucosal SO2 (73%) decreased to 55% after ligation of IMA and to 39% after complete devascularisation. The sigmoid serosal SO2 did not show any change after ligation of IMA and showed only 7% decrease after devascularisation. There was no difference in baseline SO2 and LDF values in different parts of the bowel but the mean mucosal baseline SO2 (75%) was significantly lower than that in the serosa (87%). In conclusion, mucosal SO2 measurements can accurately diagnose bowel ischaemia but serosal SO2 does not reflect mucosal ischaemia.

Keywords

Surface Probe Inferior Mesenteric Artery Laser Doppler Flowmetry Bowel Ischaemia Tissue Oxygen Saturation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Daya B. Singh
    • 1
  • Gerard Stansby
    • 2
  • Iain Bain
    • 1
  • David K. Harrison
    • 1
  1. 1.Department of Medical PhysicsUniversity Hospital of North DurhamDurhamUK
  2. 2.Northern Vascular UnitFreeman HospitalNewcastle upon TyneUK

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