Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 11;8(4):660-667.
doi: 10.1002/ags3.12768. eCollection 2024 Jul.

The relationship between perioperative central venous oxygen saturation and postoperative complications in highly invasive gastroenterological surgery

Dai Miyazaki  1 , Toshiaki Shichinohe  1 , Yusuke Watanabe  1 , Kimitaka Tanaka  1 , Yoshitsugu Nakanishi  1 , Toshimichi Asano  1 , Yo Kurashima  1 , Yuma Ebihara  1 , Soichi Murakami  1 , Satoshi Hirano  1
Affiliations

The relationship between perioperative central venous oxygen saturation and postoperative complications in highly invasive gastroenterological surgery

Dai Miyazaki et al. Ann Gastroenterol Surg. .

Abstract

Purpose: Operations for malignant diseases of the bile duct, pancreas, and esophagus are the most invasive gastroenterological surgeries. The frequency of complications after these surgeries is high, which affects the postoperative course and mortality. In patients who undergo these types of surgeries, continuous monitoring of the perioperative central venous oxygen saturation (ScvO2) is possible via a central venous catheter. We aimed to investigate the relationship between continuously monitored perioperative ScvO2 values and postoperative complications.

Methods: The medical records of 115 patients who underwent highly invasive gastroenterological surgeries and ScvO2 monitoring from April 2012 to March 2014 were analyzed. Sixty patients met the inclusion criteria, and their ScvO2 levels were continuously monitored perioperatively. The relationship between ScvO2 levels and major postoperative complications, defined as Clavien-Dindo grade ≥ III, was examined using uni- and multivariate analysis.

Results: Thirty patients developed major postoperative complications. The adequate cut-off value derived from receiver operating curves of the postoperative average ScvO2 levels for predicting major complications was 75%. Multivariate analysis revealed that low average postoperative ScvO2 levels (p = 0.016) and blood loss ≥ 1000 mL (p = 0.039) were significant predictors of major postoperative complications.

Conclusions: Low perioperative ScvO2 values were associated with an increased risk of major postoperative complications. Continuous ScvO2 monitoring will help prevent postoperative complications.

Keywords: anastomotic failure; central venous oxygen saturation; gastroenterological surgery; postoperative complications; surgical site infection.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest for this article.

Figures

FIGURE 1
FIGURE 1
Flow diagram of this study. The intraoperative ScvO2 of 115 patients was monitored. Nine patients were excluded due to the surgical procedure received and 46 patients were excluded because of incomplete ScvO2 data. The remaining 60 cases were included. Major complications graded as Clavien–Dindo ≥ III were observed in 30 patients. ScvO2, central venous oxygen saturation.
FIGURE 2
FIGURE 2
Range of perioperative ScvO2. The postoperative ScvO2 was monitored for up to 12 h. ScvO2, central venous oxygen saturation.
FIGURE 3
FIGURE 3
ROC curve of postoperative ScvO2 (average) and major complications; 75% was the most suitable threshold. ROC, receiver operating characteristics; ScvO2, central venous oxygen saturation.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Weiser TG, Haynes AB, Molina G, Lipsitz SR, Esquivel MM, Uribe‐Leitz T, et al. Estimate of the global volume of surgery in 2012: an assessment supporting improved health outcomes. Lancet. 2015;385(Suppl 2):S11. - PubMed
    1. Behrman SW, Rush BT, Dilawari RA. A modern analysis of morbidity after pancreatic resection. Am Surg. 2004;70(8):675–682. discussion 82–83. - PubMed
    1. Hirano S, Kondo S, Tanaka E, Shichinohe T, Tsuchikawa T, Kato K, et al. Outcome of surgical treatment of hilar cholangiocarcinoma: a special reference to postoperative morbidity and mortality. J Hepatobil Pancreat Sci. 2010;17(4):455–462. - PubMed
    1. McCulloch P, Ward J, Tekkis PP. ASCOT group of surgeons, British Oesophago‐gastric cancer group. Mortality and morbidity in gastro‐oesophageal cancer surgery: initial results of ASCOT multicentre prospective cohort study. BMJ. 2003;327(7425):1192–1197. - PMC - PubMed
    1. Sheridan WG, Lowndes RH, Young HL. Tissue oxygen tension as a predictor of colonic anastomotic healing. Dis Colon Rectum. 1987;30(11):867–871. - PubMed