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 (rSO2), measured using near-infrared spectroscopy (NIRS), serves as a reliable indicator of cerebral perfusion. This study aims to investigate the relationship between intraoperative rSO2 changes, perioperative outcomes, and neurological complications. Methods: This retrospective study analyzed 218 elderly patients undergoing laparoscopic partial hepatectomy, grouped based on intraoperative rSO2 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 rSO2 reductions were linked to higher risks of neurological complications. Patients with ≥20% rSO2 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 rSO2 reductions. Patients with marked rSO2 drops also experienced prolonged hospital stays. Conclusion: Intraoperative rSO2 reductions, especially >20%, are linked to adverse neurological outcomes and delayed recovery. Combined rSO2 and NSE monitoring offers a robust strategy to optimize cerebral perfusion and improve outcomes.