Division of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
J Invest Surg. 2022 Apr;35(4):809-813. doi: 10.1080/08941939.2021.1968080. Epub 2021 Sep 20.
One cause of anastomotic leakage after radical esophagectomy is blood flow insufficiency at the cervical anastomosis site. .
Eighteen patients, who underwent radical esophagectomy with gastric tube reconstruction, were studied. The regional tissue oxygen saturation (rSO2) was measured at the tip (point pre 0) and 2, 4, and 6 cm on the distal side of the tip (point pre 1, pre 2, and pre 3, respectively) before the gastric tube was raised to the cervical site through the retrosternal route. After that, rSO2 was measured at the tip, 2 and 4 cm on the distal side of the tip (points post 0, post 1, and post 2), the actual anastomotic site (point AN), and the chest skin as an indicator of whole-body oxygenation. The relationship between rSO2 scores and the rate of anastomotic leakage was determined.
The mean rSO2 at pre 0, pre 1, pre 2, and pre 3 were 48.9%, 52.3%, 54.8%, and 56.9%, respectively ( < 0.05). The mean rSO2 at post 0, post 1, and post 2 were 47.8%, 50.5%, and 52.3%, respectively, and the rSO2 at point AN was 52.1%.Anastomotic leakage was found in 6 patients. The rSO2 at points pre 0, pre 1, and pre 2, post 0 and point AN were significantly lower in patients with anastomosis leakage than those without ( < 0.05).
Tissue oxygen saturation monitoring was a useful indicator of blood flow insufficiency in the gastric tube during radical esophagectomy.
根治性食管切除术后吻合口漏的一个原因是颈部吻合口部位的血流不足。
研究了 18 例接受胃管重建的根治性食管切除术患者。在胃管通过胸骨后路径升高至颈部部位之前，测量尖端（点 pre 0）和尖端远端的 2、4 和 6cm 处（分别为点 pre 1、pre 2 和 pre 3）的区域组织氧饱和度（rSO2）。之后，在尖端、尖端远端的 2 和 4cm 处（点 post 0、post 1 和 post 2）、实际吻合部位（点 AN）和胸部皮肤处测量 rSO2，胸部皮肤作为全身氧合的指标。确定 rSO2 评分与吻合口漏的发生率之间的关系。
pre 0、pre 1、pre 2 和 pre 3 处 rSO2 的平均值分别为 48.9%、52.3%、54.8%和 56.9%（ < 0.05）。post 0、post 1 和 post 2 处 rSO2 的平均值分别为 47.8%、50.5%和 52.3%，AN 点处 rSO2 为 52.1%。6 例患者发生吻合口漏。吻合口漏患者的 pre 0、pre 1 和 pre 2 点以及 post 0 点和 AN 点的 rSO2 明显低于无吻合口漏的患者（ < 0.05）。
组织氧饱和度监测是根治性食管切除术中胃管血流不足的有用指标。
