- 标题
- 摘要
- 关键词
- 实验方案
- 产品
-
Clinical efficacy of bowel perfusion assessment during laparoscopic colorectal resection using laser speckle contrast imaging: A matched case–control study
摘要： Introduction: Disadvantages of bowel perfusion assessment with indocyanine green fluorescence angiography include the need for a fluorophore and the subjective nature of the assessment. This study was performed to evaluate the clinical efficacy of bowel perfusion assessment using laser speckle contrast imaging (LSCI) during laparoscopic colorectal surgery. Methods: The study population comprised the first 27 consecutive patients who underwent laparoscopic left-sided colorectal resection with intraoperative perfusion assessment using LSCI. The operative outcomes of these patients were compared with those of a matched group of patients without perfusion assessment. We analyzed the flux data expressed in laser speckle perfusion units. Results: After propensity score matching, we found no significant between-group differences in the patients' characteristics with the exception of the cancer stage. No patients undergoing LSCI perfusion assessment developed anastomotic leakage, but five (18.5%) patients in the control group did, at a significantly higher rate in male patients (P = .042). There were no significant differences in other operative outcomes. The laser speckle perfusion unit values after ligating marginal vessels were significantly lower than before ligation (P < .01). Conclusions: With respect to anastomotic leakage, LSCI may improve patient outcomes after colorectal surgery. This technique appears to be a superior tool with the advantages of measurement repeatability and quantitativity and no need for a fluorophore.
关键词： fluorescence angiography,anastomotic leakage,colorectal cancer
更新于2025-09-12 10:27:22
-
Quantitative Assessment of the Blood Perfusion of the Gastric Conduit by Indocyanine Green Imaging
摘要： Background: Indocyanine green (ICG) ?uorescence imaging has been used to assess the blood perfusion of the gastrointestinal tract in surgery. Especially, it was used to determine the best anastomotic site. However, in previous studies, ICG ?uorescence was judged subjectively based on the visual appearance. This study evaluated the usefulness of our novel method to quantitatively assess the blood perfusion of the gastric conduit in esophagectomy based on ICG ?uorescence. Materials and methods: Twenty patients who underwent esophagectomy with gastric conduit reconstruction were prospectively investigated. Using a camera in contact with the surface of the stomach, ICG images were quantitatively evaluated using “ROIs”, a software program that quanti?ed the ?uorescence intensity and created a time-?uorescence intensity curve to assess the blood perfusion three times intraoperatively. Results: No postoperative esophago-gastrostomy leakage developed. However, after preparing the gastric conduit and just before anastomosis, the maximum increase in ?uorescence intensity (FImax) signi?cantly decreased (48.8 (cid:1) 26.0 and 31.5 (cid:1) 14.9 versus 84.9 (cid:1) 28.2; P < 0.001 and P < 0.001, respectively), and the time to reach FImax was signi?cantly extended (60 (cid:1) 35.4 and 58.3 (cid:1) 34.9 versus 18.9 (cid:1) 6.5; P < 0.001 and P < 0.002, respectively), in comparison to the control value. Just before anastomosis, 18 cases (90%) showed an identical pattern characterized by an obtuse and low arterial in?ow peak and a slow rise of ?uorescence intensity over time, indicating a decreased blood ?ow. Conclusions: The quantitative analysis of ICG ?uorescence imaging could objectively prove a decrease in blood perfusiondwhich could not be determined macroscopicallydin the gastric conduit before esophageal reconstruction. The results from the present and further studies may indicate its clinical value.
关键词： Gastric conduit,Anastomotic leakage,Indocyanine green,Esophagectomy,Blood perfusion,Quantitative assessment
更新于2025-09-04 15:30:14