PhD defence A.L.M. (Arthur) Tavy

Anastomotic leakage (AL) remains a dreaded complication following abdominal surgery as it leads to higher morbidity, higher in-hospital mortality and worse long-term outcome (1,2). Inadequate bowel perfusion has been associated with the occurrence of AL and clinical assessment of anastomotic viability during surgery remains challenging (3–8). Therefore, devices which can aid in the assessment of bowel perfusion have recently gathered much interest and could potentially reduce the incidence of AL. When seeking to improve anastomotic perfusion one aspect is intraoperative confirmation of adequate perfusion of the anastomosis. A second aspect is optimizing perioperative hemodynamic management. In clinical practice macrohemodynamic variables, such as blood pressure, are commonly used for both monitoring and as a target for resuscitation with the aim being perseverance of tissue
oxygenation in the target organs. However, microcirculatory perfusion is not always coupled to macrohemodynamic factors (9). With the microcirculation being formed by vessels with a diameter < 20 μm: the arterioles, venules and capillaries (10). Microcirculatory function of the intestine, and its relationship to macrohemodynamic factors, during surgery remains unclear. As current literature mainly consists of animal studies and results are inconclusive. Further examining the relationship between the micro- and microcirculation could potentially lead to improvements in perioperative hemodynamic management.

The PhD defences will not take place publicly in the usual way. A live stream link has been provided to candidate. The ceremony will begin exactly at 10:30.