Correlation of Cerebral Oxygen Saturation Change with Perioperative Complications in Elderly Patients Who Underwent Laparoscopic Partial Hepatectomy

Background: Laparoscopic partial hepatectomy is a crucial treatment for primary liver cancer but is associated with risks such as bleeding and organ hypoperfusion due to controlled low central venous pressure (CLCVP). Regional cerebral oxygen saturation (rSO 2 ), measured using near-infrared spectroscopy (NIRS), serves as a reliable indicator of cerebral perfusion. This study aims to investigate the relationship between intraoperative rSO 2 changes, perioperative outcomes, and neurological complications. Methods: This retrospective study analyzed 218 elderly patients undergoing laparoscopic partial hepatectomy, grouped based on intraoperative rSO 2 reductions of ≥ 10% and ≥ 20%. Perioperative complications were assessed. Serum neuron-specific enolase (NSE) levels were measured on postoperative day 3 via enzyme-linked immunosorbent assay. Hemodynamic parameters, including mean arterial pressure (MAP), were monitored intraoperatively. Results: Among the 218 patients, significant rSO 2 reductions were linked to higher risks of neurological complications. Patients with ≥ 20% rSO 2 reductions had increased incidences of delirium (30.5% vs 13.0%, p = 0.002), and elevated serum NSE levels (p < 0.05). Declines in MAP during critical intraoperative periods were associated with rSO 2 reductions. Patients with marked rSO 2 drops also experienced prolonged hospital stays. Conclusion: Intraoperative rSO 2 reductions, especially > 20%, are linked to adverse neurological outcomes and delayed recovery. Combined rSO 2 and NSE monitoring offers a robust strategy to optimize cerebral perfusion and improve outcomes. Keywords: perioperative complications NSE, rSO 2 , cerebral perfusion, outcome