Value of intraoperative tissue oxygen saturation in predicting anastomotic healing in patients with colon cancer

Objective: To explore the value of intraoperative tissue oxygen saturation (StO₂) in predicting postoperative anastomotic healing in patients with colon cancer. Methods: A total of 100 patients with colon cancer were selected as the study subjects,and all of them were subjected to radical colectomy.Indocyanine green (ICG) fluorescence imaging technique was used to assist the anastomosis during the operation,and StO₂ in different parts was monitored at the same time.Pearson correlation analysis was used to analyze the correlation between StO₂ level in tissue and the distance from the transverse part.The anastomotic healing was observed 30 days after operation and divided into anastomotic leakage (AL) group and non-AL group according to whether it healed or not.The influencing factors of postoperative anastomotic healing were screened by multivariate logistic analysis,and the ROC curve was drawn to evaluate the predictive value of StO₂ during operation for postoperative anastomotic healing of colon cancer patients. Results: At 30 days after surgery,4 cases of AL were classified into AL group,the incidence of AL was 4.00%,all of which healed after antibiotic and drainage treatment,and the other 96 cases were classified into non-AL group.StO₂ measurements were performed at 2 cm intervals,with 6 points plotted along the location of the point where the fluorescence perfusion ended.Position 0 represented the end point of fluorescence perfusion (the transverse site),and position 5 represented the distal end of the transverse site (10 cm).Correlation analysis showed that StO₂ levels decreased with increasing distance from the transverse site (r=0.908,P<0.01).Compared with non-AL group,the proportion of diabetes mellitus and preoperative neoadjuvant therapy in AL group was higher,and the StO₂ level at the transverse site (0 point) was lower than that in non-AL group (P<0.05).Multivariate Logistic regression analysis showed that StO₂(OR=0.622,95%CI:0.392-0.988) at the cross-sectional site was a protective factor for anastomotic healing after colon cancer surgery (P<0.05).ROC curve showed that the AUC of StO₂ in predicting postoperative anastomotic healing of colon cancer was 0.833(95%CI:0.746-0.900),the specificity was 97.92%,the sensitivity was 75.00%,and the best cutoff value was 0.56. Conclusions: Intraoperative StO₂ can evaluate anastomotic blood flow in patients with colon cancer,and has certain predictive value for postoperative anastomotic healing.