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.