Surface Microdialysis for Detection of Colorectal Anastomosis Ischemia—An Experimental Study

Inadequate blood supply is one of the major risk factors for anastomotic leak after low anterior rectal resection. Early detection of ischemia might predict complicated healing and enable anastomotic salvage, which is associated with better outcomes. A microdialysis offers a real-time evaluation of...

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Bibliographic Details
Published in:The Journal of surgical research 2021-05, Vol.261, p.293-300
Main Authors: Ryska, Ondrej, Kalvach, Jaroslav, Pazin, Jaroslav, Hadac, Jan, Martinek, Jan, Juhas, Stefan, Juhasova, Jana
Format: Article
Language:English
Subjects:
Anastomotic leak
Anterior resection
Microdialysis
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Summary:Inadequate blood supply is one of the major risk factors for anastomotic leak after low anterior rectal resection. Early detection of ischemia might predict complicated healing and enable anastomotic salvage, which is associated with better outcomes. A microdialysis offers a real-time evaluation of adequate bowel perfusion through monitoring of tissue metabolism. In this experimental study, we assessed the role of microdialysis in detecting early ischemia after colorectal anastomosis. Colorectal anastomosis was performed in six miniature pigs. A microdialysis catheter was placed on the bowel serosa 5 mm proximal to the anastomosis. Metabolic changes were monitored hourly before and after initiating ischemia, which was induced by ligation of the inferior mesenteric artery and skeletonization of the mesocolon. Significant increase in tissue levels of lactate was detected after 60 min of ischemia (13.6 [10.4-16.1] versus 6.75 [1.8-9.6] mmol/L at baseline; P 
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2020.12.021