Zhang Xiao-Qiang, Zhang Chao-Fu, Zhou Xiang-Jun, Shuai Lei-Yuan, Peng Dong, Ji Guang-Yan
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuanjiagang District, Chongqing, 400016, China.
Department of Anorectal Surgery, Jiangjin Central Hospital of Chongqing, Chongqing, 404000, China.
Int J Colorectal Dis. 2025 Mar 18;40(1):71. doi: 10.1007/s00384-025-04864-3.
Anastomotic leakage (AL) is one of the most serious clinical complications in digestive tract reconstruction (DTR) surgery, and it is currently hypothesized that this may be related to insufficient anastomotic blood supply. Thus, Therefore, we aimed to assess the ability of tissue oxygen saturation(StO) as a measure to evaluate anastomotic blood supply.
A comprehensive literature search was performed using Embase, PubMed and Cochrane Library. StO was used as an evaluation index of anastomotic blood supply after DTR to analyze the potential association between this index and the occurrence of AL in the postoperative period.
A total of eleven articles involving 867 participants were included in this systematic review and meta-analysis. After pooling the standardized mean difference (SMD) and 95% confidence intervals (Cls), low StO was found to be an independent risk factor for AL (P < 0.00001; 95%CI: 1.02 [0.53-1.51]). The mean StO in the AL group (62.3%) was significantly lower than that in the non-AL group (74.3%); AL incidence increased with the reduction of StO to a certain value to 201.8% and 338.1% respectively.
Oxygen saturation index can be utilized in DTR to accurately and quantitatively evaluate the anastomotic blood supply to reduce the probability of postoperative AL.
吻合口漏（AL）是消化道重建（DTR）手术中最严重的临床并发症之一，目前推测这可能与吻合口血供不足有关。因此，我们旨在评估组织氧饱和度（StO）作为评估吻合口血供指标的能力。
使用Embase、PubMed和Cochrane图书馆进行全面的文献检索。将StO用作DTR后吻合口血供的评估指标，分析该指标与术后AL发生之间的潜在关联。
本系统评价和荟萃分析共纳入11篇文章，涉及867名参与者。汇总标准化均数差（SMD）和95%置信区间（Cls）后，发现低StO是AL的独立危险因素（P < 0.00001；95%CI：1.02 [0.53 - 1.51]）。AL组的平均StO（62.3%）显著低于非AL组（74.3%）；随着StO降至一定值，AL发生率分别增加至201.8%和338.1%。
氧饱和度指数可用于DTR，以准确、定量地评估吻合口血供，降低术后AL的发生概率。
