J.Jpn. Surg. Soc.. 83(12): 1398-1410, 1982

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Original article

STUDIES ON THE RELATIONSHIP BETWEEN TISSUE OXYGEN TENSION AND ANASTOMOTIC HEALING OF ISCHEMIC SMALL INTESTINE IN DOG AND HUMAN

This study deals with the close relationship between tissue oxygen tension of the digestive tract and the capability of the intestine to heal an anastomosis following surgical devascularization.
A reproducible model of surgically devascularized intestine was obtained in 117 dogs by ligation and extripation of the intestinal terminal vessels over a designed length. PO₂ in the muscle layer was measured at the midpoint of the intestinal segments with a micro oxygen electrode. Tissue segments with a PO₂ less than 20mmHg were survived by 15％, whereas all subjects with a PO₂ more than 20mmHg were survived. In a separate experiment, a group of dogs was received anastomosis at the midpoint of the ischemic segment. Segments with a PO₂く30mmHg usually leaked (69％), whereas all (100％) segments with a PO₂ ≧ 30mmHg healed.
The observation on 19 patients undergoing esophageal resection and anastomosis showed a significant correlation between low PO₂ in the tissue and subsequent leakage from the anastomotic region.
It is concluded that tissue oxygen tension is an important determinant of postsurgical intestinal viability and that measurement of this parameter during operation may serve as a guide for the construction of a successful anastomosis.

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