Perianastomotic pH monitoring consistently detected lower pH values in patients with anastomotic leaks and may shorten detection time versus conventional methods, though no standard cut-off exists.
Systematic Review
Does perianastomotic pH monitoring improve the early detection of anastomotic leaks in gastrointestinal surgery?
Perianastomotic pH monitoring shows potential for the early detection of anastomotic leaks after GI surgery, but standardized protocols and cut-offs are lacking.
IntroductionAnastomotic leak (AL) represents a significant complication following gastrointestinal (GI) surgery, contributing to increased morbidity and mortality. pH monitoring has emerged as a potential diagnostic tool for the early detection of AL, but its effectiveness and clinical utility remain to be fully elucidated. This review aims to summarise the evidence regarding perianastomotic pH monitoring for AL detection.MethodsA systematic search of relevant databases was conducted to identify pre-clinical and clinical studies investigating pH monitoring for AL detection following GI surgery. Studies were screened by two independent reviewers based on predefined inclusion and exclusion criteria. Data were extracted and presented as a narrative synthesis.ResultsA total of 10 studies were included in the review, comprising animal studies (n = 2), and human studies in upper GI (n = 3) and colorectal (n = 5) patients. Consistent findings of lower pH values in patients with AL across various postoperative time points were demonstrated. There was diversity in the pH detection method, in addition to variable frequency and timing of pH monitoring. Four studies reported a shorter time for AL detection with pH monitoring vs conventional methods, although no statistical comparisons were used. No standard pH cut-off value for AL detection was identified.ConclusionpH monitoring shows potential as a diagnostic tool for the early detection of AL following GI surgery. While the existing evidence supports its potential utility, further research is required to establish standardised protocols and assess its clinical impact.
Walshaw et al. (Tue,) conducted a systematic review in Anastomotic leak following gastrointestinal surgery. Perianastomotic pH monitoring vs. Conventional methods was evaluated on Early detection of anastomotic leak. Perianastomotic pH monitoring consistently detected lower pH values in patients with anastomotic leaks and may shorten detection time versus conventional methods, though no standard cut-off exists.