BACKGROUND Adequate tissue oxygenation and perfusion remain fundamental to safe bowel resection surgery. Near infrared (NIR) imaging using indocyanine green has proven itself superior to clinical evaluation alone in assessing bowel perfusion, but requires expensive equipment not readily available in many centers. METHODS We studied the IntraOx device (Vioptix Inc, Newark, CA USA), a handheld, tissue oxygen saturation assessment tool, to assess whether tissue bed oxygen saturation (StO2) is comparable to NIR assessment of bowel viability. Patients undergoing elective colon resection for benign and malignant disease were included. After choosing a clinical margin (CM) and dividing the mesentery, StO2 was measured at 5-cm intervals along the colon. A tissue oxygen saturation margin (TOM) was assigned where StO2 dropped off by at least 10 percentage points. NIR perfusion was then assessed to determine NIR margin (NIRM). Intraoperative and postoperative data were collected. RESULTS 32 consecutive patients undergoing colectomies were analyzed. IntraOx sensitivity was 90.6%, specificity was 94.3%. The mean StO2 difference across the NIRM was 23.1%. In all but one case, the TOM matched the NIRM. In 3 cases, the TOM and NIRM concurred, but were a mean of 3.3 cm proximal to the CM and altered the surgical plan. At 4-week follow-up, no significant complications were reported. CONCLUSIONS The IntraOx device consistently identified a margin of significant saturation "drop-off" which correlated with the findings on NIR perfusion and clinical assessment. These early data indicate that StO2 measurement may be equivalent to NIR assessment of bowel perfusion. In addition, the IntraOx device may be a more cost-effective solution for surgeons looking for adjunctive evaluation of bowel viability. More study is warranted in a larger group of patients to confirm these preliminary findings and to judge the impact of StO2 assessment on reducing anastomotic leaks.

中文翻译：

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与吲哚菁绿成像相比，使用组织氧测量来评估人体肠道的术中组织活力。

背景充分的组织氧合和灌注仍然是安全肠切除手术的基础。使用吲哚菁绿的近红外 (NIR) 成像已证明其在评估肠道灌注方面优于单独的临床评估，但需要昂贵的设备，而许多中心并不容易获得。方法 我们研究了 IntraOx 设备（Vioptix Inc, Newark, CA USA），一种手持式组织氧饱和度评估工具，以评估组织床氧饱和度 (StO2) 是否与 NIR 对肠道活力的评估相当。包括因良性和恶性疾病而接受选择性结肠切除术的患者。选择临床边缘 (CM) 并分割肠系膜后，沿结肠每隔 5 厘米测量 StO2。当 StO2 下降至少 10 个百分点时，分配了组织氧饱和度边缘 (TOM)。然后评估 NIR 灌注以确定 NIR 边缘 (NIRM)。收集术中和术后数据。结果 分析了 32 名连续接受结肠切除术的患者。IntraOx 敏感性为 90.6%，特异性为 94.3%。NIRM 的平均 StO2 差异为 23.1%。除一种情况外，TOM 均与 NIRM 相匹配。在 3 例中，TOM 和 NIRM 一致，但均值接近 CM 3.3 cm，并改变了手术计划。在 4 周的随访中，没有报告明显的并发症。结论 IntraOx 设备始终识别出明显的饱和度“下降”边缘，这与 NIR 灌注和临床评估的结果相关。这些早期数据表明，StO2 测量可能等同于肠道灌注的 NIR 评估。此外，IntraOx 装置对于寻求肠道活力辅助评估的外科医生来说可能是一种更具成本效益的解决方案。需要在更大的患者群体中进行更多的研究，以确认这些初步发现并判断 StO2 评估对减少吻合口漏的影响。