EARLY PREDICTION OF THE RISK OF SMALL INTESTINAL ANASTOMOTIC LEAKAGE BASED ON PULSE OXIMETRY PARAMETERS

Abstract

This thesis examines the possibilities of early prediction of the risk of small intestinal anastomotic leakage based on pulse oximetry parameters through a review of the literature. The aim of the study is to describe approaches for investigating the relationship between local oxygen saturation recorded intraoperatively in intestinal segments where an anastomosis is to be formed and postoperative anastomotic leakage. In this context, early prediction is interpreted as assessing the risk of potential complications using measurements obtained during surgery.

The analysis distinguishes local pulse oximetry parameters obtained using a sensor suitable for application to the intestinal wall from peripheral SpO₂. Experimental studies have compared pulse oximetry values with anastomotic outcomes under conditions of small intestinal ischemia; however, these findings do not establish a universal prognostic threshold for patients. The need to consider sensor placement, signal quality, measurement timing, hemodynamic status, and surgical characteristics when interpreting measurements is discussed.

The thesis proposes an approach to evaluating prognostic value based on standardized measurements, a predefined definition of anastomotic leakage, and consistent clinical follow-up. Particular attention is paid to determining the additional information provided by local measurements beyond conventional surgical assessment and clinical factors. High saturation is not interpreted as a guarantee of uncomplicated healing, nor is a low value considered an independent decision-making criterion. No new clinical data are presented; determining the accuracy and practical value of pulse oximetry for early prediction is identified as a task for future clinical studies.