WP 2.23: Intestinal anastomotic microcirculation: a matter of an objective approach

Due to colorectal cancer, ~3000 colorectal resections are performed annually in Denmark. The procedure is often complicated by anastomosis leakage (AL) and postoperative ileus (POI), leading to increased patient morbidity. Recent research suggests that active treatment with gastric pacing could reduce the POI burden, and clinical trials are currently pending.

Literature shows that POI increases the risk of anastomotic leakage (AL), an association that could be mediated through decreased microcirculation leading to impaired anastomosis healing. Nevertheless, this has never previously been investigated. Moreover, an objective tool for perioperative evaluation of the microcirculation has until now been unavailable; Currently, the evaluation of the intestinal microcirculation is done by subjective assessment of the tissue color, bleeding, and arterial pulsation by the surgeon. However, Laser Speckle Contrast Imaging (LSCI) is an emerging new tool for objective measurement of the microcirculation, which could support the surgeon’s perioperative evaluation of the microcirculation, and thus healing potential, in an anastomosis.

Therefore, the scope of this project is to investigate microcirculation with LSCI and promote the transfer of LSCI into the clinic. We will do this by combining porcine studies with a clinical human trial. The results will contribute to the knowledge of microcirculation around anastomosis in colorectal surgery, with especial focus on complications as POI and AL. Further, results will show whether it is feasible to implement laparoscopic LSCI measurements in a clinical setting to support the surgeon’s evaluation of the intestinal microcirculation. In time, such a support tool could improve patient healing after onco-surgery.

Awarded to: Mai-Britt Worm Ørntoft (Gødstrup Hospital) – CFA2

Awarded grant to suport VIP personnel.