Open AccessHow to assess intestinal viability during surgery: A review of techniques
Author(s) -
Linas Urbanavičius,
Piet Pattyn,
Dirk Van de Putte,
Donatas Venskutonis
Publication year - 2011
Publication title -
world journal of gastrointestinal surgery
Language(s) - English
Resource type - Journals
ISSN - 1948-9366
DOI - 10.4240/wjgs.v3.i5.59
Subject(s) - medicine , surgery , stoma (medicine) , limiting , anastomosis , intestinal ischemia , intensive care medicine , general surgery , ischemia , reperfusion injury , mechanical engineering , engineering
Objective and quantitative intraoperative methods of bowel viability assessment are essential in gastrointestinal surgery. Exact determination of the borderline of the viable bowel with the help of an objective test could result in a decrease of postoperative ischemic complications. An accurate, reproducible and cost effective method is desirable in every operating theater dealing with abdominal operations. Numerous techniques assessing various parameters of intestinal viability are described by the studies. However, there is no consensus about their clinical use. To evaluate the available methods, a systematic search of the English literature was performed. Virtues and drawbacks of the techniques and possibilities of clinical application are reviewed. Valuable parameters related to postoperative intestinal anastomotic or stoma complications are analyzed. Important issues in the measurement and interpretation of bowel viability are discussed. To date, only a few methods are applicable in surgical practice. Further studies are needed to determine the limiting values of intestinal tissue oxygenation and flow indicative of ischemic complications and to standardize the methods.