Prevention of Anastomotic Leakage after Total Gastrectomy with Perioperative Supplemental Oxygen Administration: A Prospective Randomized, Double-blind, Controlled, Single-center Trial

Abstract

Supplemental 80 % FiO2 provided during and for 6 h after major gastric cancer surgery to reduce postoperative anastomotic dehiscence should be considered part of ongoing quality improvement activities related to surgical care, with few risks to the patient and little associated cost.

BTS guideline for oxygen use in adults in healthcare and emergency settings

“…The risk of anastomotic leak was 46% lower in the 80% FiO 2 group (RR 0.63; 95% CI 0.42 to 0.98) versus the 30% FiO 2 group. The same group has shown similar results in patients with oesophagojejunal anastomosis when the risk of anastomotic leak was 49% lower in the 80% FiO 2 group (RR 0.61; 95% CI 0.40 to 0.95) versus the 30% FiO 2 group 389. However, the numbers of patients in both studies in each treatment arm were small and further work is required from other investigators to validate this finding, especially in view of the concerns of Meyhoff et al 383 that high-concentration oxygen may increase medium-term mortality in patients having cancer surgery.…”

RETRACTED: High-concentration supplemental perioperative oxygen and surgical site infection following elective colorectal surgery for rectal cancer: a prospective, randomized, double-blind, controlled, single-site trial

“…There were various reasons for administering oxygen for 6 hours after surgery. 34,35 It was known from previous studies that the relative anastomotic ischemia was transitory 36 and limited to the first 24 hours after surgery. Patients may tolerate a mask that delivers a high oxygen concentration for a few hours after surgery, but such concentration would be difficult to maintain for longer periods owing to patient discomfort; for this reason the supplemental oxygen therapy was restricted to 6 hours after surgery.…”

New Harmonic Scalpel versus Conventional Hemostasis in Right Colon Surgery: A Prospective Randomized Controlled Clinical Trial

“…In fact, as shown in table 3, in the NHS group there was a significant difference in the rate of septic complications (surgical site infections and intra-abdominal sepsis). In our opinion, the lack of significant differences in anastomotic leakage is due to its correlation with poor tissue oxygenation rather than protein depletion [30,31]. …”