Anastomotic Leak Detection by Electrolyte Electrical Resistance

ABSTRACT

Objective: To characterize a new method of postoperative gastrointestinal leak detection based on electrical resistance changes due to extravasated electrolyte contrast. Background: Postoperative gastrointestinal leak results in increased patient morbidity, mortality, and hospital costs that can be mitigated by early diagnosis. A sensitive and specific diagnostic test that could be performed at the bedside has the potential to shorten the time to diagnosis and thereby improve the quality of treatment. Materials and Methods: Anaesthetized rats underwent celiotomy and creation of a 5-mm gastrotomy. In experimental animals, electrical resistance changes were measured with a direct current ohmmeter after the introduction of 5 cc of 23.4% NaCl electrolyte solution via gavage and measured with a more sensitive alternating current ohmmeter after the gavage of 1–5 cc of 0.9% NaCl. Comparison was made to negative controls and statistical analysis was performed. Results: Leakage from the gastrotomy induced by as little as 1 cc of gavage-delivered 0.9% NaCl contrast solution was detectable as a statistically significant drop in electrical resistance when compared to results from negative controls. Conclusion: Electrical resistance change associated with electrolyte-gated leak detection is highly sensitive and specific and has the potential to be rapidly translated into clinical settings.

Keywords::

• anastomotic leak
• gastrointestinal surgery
• postoperative complications
• bioimpedance
• esophageal surgery
• quality assurance

ACKNOWLEDGEMENTS

We would like to express deep gratitude to the Morrison Trust of San Antonio, TX whose grant primarily funded this study, as well as our thanks to South Texas Technology Management of the University of Texas for support of this study through a POCSparc grant.