Dai Miyazaki, Toshiaki Shichinohe, Yusuke Watanabe, Kimitaka Tanaka, Yoshitsugu Nakanishi, Toshimichi Asano, Yo Kurashima, Yuma Ebihara, Soichi Murakami, Satoshi Hirano
{"title":"高创胃肠外科手术围手术期中心静脉血氧饱和度与术后并发症的关系","authors":"Dai Miyazaki, Toshiaki Shichinohe, Yusuke Watanabe, Kimitaka Tanaka, Yoshitsugu Nakanishi, Toshimichi Asano, Yo Kurashima, Yuma Ebihara, Soichi Murakami, Satoshi Hirano","doi":"10.1002/ags3.12768","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>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 (ScvO<sub>2</sub>) is possible via a central venous catheter. We aimed to investigate the relationship between continuously monitored perioperative ScvO<sub>2</sub> values and postoperative complications.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The medical records of 115 patients who underwent highly invasive gastroenterological surgeries and ScvO<sub>2</sub> monitoring from April 2012 to March 2014 were analyzed. Sixty patients met the inclusion criteria, and their ScvO<sub>2</sub> levels were continuously monitored perioperatively. The relationship between ScvO<sub>2</sub> levels and major postoperative complications, defined as Clavien–Dindo grade ≥ III, was examined using uni- and multivariate analysis.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Thirty patients developed major postoperative complications. The adequate cut-off value derived from receiver operating curves of the postoperative average ScvO<sub>2</sub> levels for predicting major complications was 75%. Multivariate analysis revealed that low average postoperative ScvO<sub>2</sub> levels (<i>p</i> = 0.016) and blood loss ≥ 1000 mL (<i>p</i> = 0.039) were significant predictors of major postoperative complications.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Low perioperative ScvO<sub>2</sub> values were associated with an increased risk of major postoperative complications. Continuous ScvO<sub>2</sub> monitoring will help prevent postoperative complications.</p>\n </section>\n </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"8 4","pages":"660-667"},"PeriodicalIF":2.9000,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12768","citationCount":"0","resultStr":"{\"title\":\"The relationship between perioperative central venous oxygen saturation and postoperative complications in highly invasive gastroenterological surgery\",\"authors\":\"Dai Miyazaki, Toshiaki Shichinohe, Yusuke Watanabe, Kimitaka Tanaka, Yoshitsugu Nakanishi, Toshimichi Asano, Yo Kurashima, Yuma Ebihara, Soichi Murakami, Satoshi Hirano\",\"doi\":\"10.1002/ags3.12768\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Purpose</h3>\\n \\n <p>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 (ScvO<sub>2</sub>) is possible via a central venous catheter. We aimed to investigate the relationship between continuously monitored perioperative ScvO<sub>2</sub> values and postoperative complications.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The medical records of 115 patients who underwent highly invasive gastroenterological surgeries and ScvO<sub>2</sub> monitoring from April 2012 to March 2014 were analyzed. Sixty patients met the inclusion criteria, and their ScvO<sub>2</sub> levels were continuously monitored perioperatively. The relationship between ScvO<sub>2</sub> levels and major postoperative complications, defined as Clavien–Dindo grade ≥ III, was examined using uni- and multivariate analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Thirty patients developed major postoperative complications. The adequate cut-off value derived from receiver operating curves of the postoperative average ScvO<sub>2</sub> levels for predicting major complications was 75%. Multivariate analysis revealed that low average postoperative ScvO<sub>2</sub> levels (<i>p</i> = 0.016) and blood loss ≥ 1000 mL (<i>p</i> = 0.039) were significant predictors of major postoperative complications.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Low perioperative ScvO<sub>2</sub> values were associated with an increased risk of major postoperative complications. Continuous ScvO<sub>2</sub> monitoring will help prevent postoperative complications.</p>\\n </section>\\n </div>\",\"PeriodicalId\":8030,\"journal\":{\"name\":\"Annals of Gastroenterological Surgery\",\"volume\":\"8 4\",\"pages\":\"660-667\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-01-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12768\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Gastroenterological Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ags3.12768\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Gastroenterological Surgery","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ags3.12768","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
The relationship between perioperative central venous oxygen saturation and postoperative complications in highly invasive gastroenterological surgery
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.
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