Abstract
Leakage and stenosis are serious complications of gastrointestinal anastomotic surgery that may, in part, be related to local ischemia. The ability to accurately quantitate the degree of gastrointestinal anastomotic ischemia remains a challenging clinical problem. The purpose of this study was to: 1) develop a model of colorectal anastomotic stenosis following local ischemia; 2) compare the accuracy of laser Doppler velocimetry and intramural colonic pH in quantitating critical levels of intestinal anastomotic ischemia; and 3) compare the anastomotic healing process using either a standard two-layer Czerny-Lembert handsewn or EEA™ stapled anastomotic technique under ischemic conditions. The studies reported here were performed in two phases. Phase I was the pilot study in which the authors developed a model of colorectal anastomotic ischemia and defined critical levels of ischemia using laser Doppler velocimetry and intramural pH (≤200 mV; ≤7.0, respectively). These parameters were then tested prospectively in Phase II, assessing the effects of anastomotic ischemia on animals kept alive for 5, 11, 21, and 60 days after surgery. Overall there was a 70 percent incidence of anastomotic healing complications in the Phase II trial with laser Doppler velocimetry correctly predicting anastomotic outcome in 70 percent of cases and tissue pH in 93 percent of cases. The results indicate that, although laser Doppler velocimetry and intramural pH measurements provide safe, easy techniques for assessing the effects of ischemia on the colorectal anastomosis, measurement of intramural pH provides an optimal quantitative method for predicting subsequent anastomotic outcome and tissue viability.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 175-179 |
| Number of pages | 5 |
| Journal | Diseases of the Colon and Rectum |
| Volume | 33 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1990 |
| Externally published | Yes |
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Keywords
- Colorectal anastomoses
- Intramural pH probe
- Ischemia
- Laser Doppler velocimetry
ASJC Scopus subject areas
- Gastroenterology
Cite this
Intramural pH : A quantitative measurement for predicting colorectal anastomotic healing. / Senagore, Anthony; Milsom, Jeffrey W.; Walshaw, Richard K.; Dunstan, Robert; Mazier, W. Patrick; Chaudry, Irshad H.
In: Diseases of the Colon and Rectum, Vol. 33, No. 3, 03.1990, p. 175-179.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intramural pH
T2 - A quantitative measurement for predicting colorectal anastomotic healing
AU - Senagore, Anthony
AU - Milsom, Jeffrey W.
AU - Walshaw, Richard K.
AU - Dunstan, Robert
AU - Mazier, W. Patrick
AU - Chaudry, Irshad H.
PY - 1990/3
Y1 - 1990/3
N2 - Leakage and stenosis are serious complications of gastrointestinal anastomotic surgery that may, in part, be related to local ischemia. The ability to accurately quantitate the degree of gastrointestinal anastomotic ischemia remains a challenging clinical problem. The purpose of this study was to: 1) develop a model of colorectal anastomotic stenosis following local ischemia; 2) compare the accuracy of laser Doppler velocimetry and intramural colonic pH in quantitating critical levels of intestinal anastomotic ischemia; and 3) compare the anastomotic healing process using either a standard two-layer Czerny-Lembert handsewn or EEA™ stapled anastomotic technique under ischemic conditions. The studies reported here were performed in two phases. Phase I was the pilot study in which the authors developed a model of colorectal anastomotic ischemia and defined critical levels of ischemia using laser Doppler velocimetry and intramural pH (≤200 mV; ≤7.0, respectively). These parameters were then tested prospectively in Phase II, assessing the effects of anastomotic ischemia on animals kept alive for 5, 11, 21, and 60 days after surgery. Overall there was a 70 percent incidence of anastomotic healing complications in the Phase II trial with laser Doppler velocimetry correctly predicting anastomotic outcome in 70 percent of cases and tissue pH in 93 percent of cases. The results indicate that, although laser Doppler velocimetry and intramural pH measurements provide safe, easy techniques for assessing the effects of ischemia on the colorectal anastomosis, measurement of intramural pH provides an optimal quantitative method for predicting subsequent anastomotic outcome and tissue viability.
AB - Leakage and stenosis are serious complications of gastrointestinal anastomotic surgery that may, in part, be related to local ischemia. The ability to accurately quantitate the degree of gastrointestinal anastomotic ischemia remains a challenging clinical problem. The purpose of this study was to: 1) develop a model of colorectal anastomotic stenosis following local ischemia; 2) compare the accuracy of laser Doppler velocimetry and intramural colonic pH in quantitating critical levels of intestinal anastomotic ischemia; and 3) compare the anastomotic healing process using either a standard two-layer Czerny-Lembert handsewn or EEA™ stapled anastomotic technique under ischemic conditions. The studies reported here were performed in two phases. Phase I was the pilot study in which the authors developed a model of colorectal anastomotic ischemia and defined critical levels of ischemia using laser Doppler velocimetry and intramural pH (≤200 mV; ≤7.0, respectively). These parameters were then tested prospectively in Phase II, assessing the effects of anastomotic ischemia on animals kept alive for 5, 11, 21, and 60 days after surgery. Overall there was a 70 percent incidence of anastomotic healing complications in the Phase II trial with laser Doppler velocimetry correctly predicting anastomotic outcome in 70 percent of cases and tissue pH in 93 percent of cases. The results indicate that, although laser Doppler velocimetry and intramural pH measurements provide safe, easy techniques for assessing the effects of ischemia on the colorectal anastomosis, measurement of intramural pH provides an optimal quantitative method for predicting subsequent anastomotic outcome and tissue viability.
KW - Colorectal anastomoses
KW - Intramural pH probe
KW - Ischemia
KW - Laser Doppler velocimetry
UR - http://www.scopus.com/inward/record.url?scp=0025278965&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025278965&partnerID=8YFLogxK
U2 - 10.1007/BF02134174
DO - 10.1007/BF02134174
M3 - Article
VL - 33
SP - 175
EP - 179
JO - Diseases of the Colon and Rectum
JF - Diseases of the Colon and Rectum
SN - 0012-3706
IS - 3
ER -