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Visualization and quantification of anastomotic perfusion in colorectal surgery using near-infrared fluorescence.

Published on Sep 18, 2019in Techniques in Coloproctology2.635
· DOI :10.1007/S10151-019-02089-5
Shinya Hayami23
Estimated H-index: 23
(Wakayama Medical University),
Kenji Matsuda14
Estimated H-index: 14
(Wakayama Medical University)
+ 10 AuthorsHirokiyamaue44
Estimated H-index: 44
(Wakayama Medical University)
Abstract
Background Anastomotic leakage (AL) is one of the most troublesome complications in colorectal surgery. Recently, near-infrared fluorescence (NIRF) imaging has been used intraoperatively to detect sentinel lymph nodes and visualize the blood supply at the region of interest (ROI). The aim of this study was to evaluate the role of visualization and quantification of bowel perfusion around the anastomosis using NIRF system in predicting AL.
  • References (27)
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References27
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#1Yuk Kwan Chang (HKU: University of Hong Kong)H-Index: 5
#2Chi Chung Foo (HKU: University of Hong Kong)H-Index: 6
Last. Wai Lun Law (HKU: University of Hong Kong)H-Index: 42
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Abstract Background Perfusion plays an important role in anastomotic healing. Indocyanine-green fluorescence angiogram allows objective bowel perfusion assessment. This study aimed to investigate the impact of perfusion assessment on intraoperative decision during left-sided colorectal resections. Method This was a prospective, single-centre, observational study recruiting patients with left-sided colorectal resections. Perfusion of bowel segment was assessed with ICG fluorescence angiogram prio...
2 CitationsSource
#1Deborah S. Keller (UCL: University College London)H-Index: 8
#2Richard Boulton (UCL: University College London)H-Index: 1
Last. Manish Chand (UCL: University College London)H-Index: 4
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Here, we report on the feasibility of ICG fluorescence imaging to localize lesions in emergent minimally invasive surgery. A 49-year old female presented to the emergency department with a previously unknown malignant bowel obstruction. She was taken emergently to the operating room for a laparoscopic extended right hemicolectomy, based on tumor location from imaging. With intraoperative difficulty localizing the lesion, an on-table colonoscopy was performed. When the tumor was encountered, peri...
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#1R. Blanco-Colino (Autonomous University of Barcelona)H-Index: 1
#2E. Espin-Basany (Autonomous University of Barcelona)H-Index: 1
Background Indocyanine green (ICG) fluorescence imaging has been proven to be an effective tool to assess anastomotic perfusion. The aim of this systematic review and meta-analysis was to evaluate its efficacy in reducing the anastomotic leakage (AL) rate after colorectal surgery.
25 CitationsSource
#1Toshiaki Wada (Kyoto University)H-Index: 8
#2Kenji Kawada (Kyoto University)H-Index: 24
Last. Yoshiharu Sakai (Kyoto University)H-Index: 40
view all 7 authors...
Background Fluorescence technology with indocyanine green (ICG) provides a real-time assessment of intestinal perfusion. However, a subjective evaluation of fluorescence intensity based on the surgeon’s visual judgement is a major limitation. This study evaluated the quantitative assessment of ICG fluorescence imaging in determining the transection line of the proximal colon during laparoscopic colorectal surgery.
28 CitationsSource
#1Kenji Kawada (Kyoto University)H-Index: 24
#2Suguru Hasegawa (Kyoto University)H-Index: 27
Last. Yoshiharu Sakai (Kyoto University)H-Index: 40
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Background Decreased blood perfusion is an important risk factor for postoperative anastomotic leakage (AL). Fluorescence imaging with indocyanine green (ICG) provides a real-time assessment of intestinal perfusion. This study evaluated the utility of ICG fluorescence imaging in determining the transection line of the proximal colon during laparoscopic colorectal surgery with double stapling technique (DST) anastomosis.
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#1Luigi Boni (University of Insubria)H-Index: 32
#2Giulia David (University of Insubria)H-Index: 6
Last. Abe Fingerhut (UoA: National and Kapodistrian University of Athens)H-Index: 56
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Aims Anastomotic leakage after colorectal surgery is a severe complication. One possible cause of anastomotic leakage is insufficient vascular supply. The aim of this study was to evaluate the feasibility and the usefulness of intraoperative assessment of vascular anastomotic perfusion in colorectal surgery using indocyanine green (ICG)-enhanced fluorescence.
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#1Naoto Nishigori (Nara Medical University)H-Index: 5
#2Fumikazu Koyama (Nara Medical University)H-Index: 14
Last. Yoshiyuki Nakajima (Nara Medical University)H-Index: 39
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Purpose In laparoscopic colorectal cancer (Lap-CRC) surgery, determination of a suitable mesentery division line and the appropriate degree of lymphadenectomy by tracing the blood supply is critical. We performed visualization of the lymph and blood flow by laparoscopic indocyanine green (ICG) fluorescence imaging (Lap-IGFI).
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#1Jörn Gröne (Charité)H-Index: 16
#2D. Koch (Charité)H-Index: 1
Last. M. E. Kreis (Charité)H-Index: 1
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Aim Inadequate intestinal blood flow may contribute to anastomotic leakage accounting for substantial morbidity and mortality in colorectal surgery. Precise intraoperative assessment of microperfusion may have an impact on the surgeon0s intraoperative management and leakage rate. Method In this single center observational study we implemented and integrated intraoperative indocyanin green (ICG) based microperfusion assessment of anastomosis with Pinpoint Perfusion Imaging in a series of consecut...
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#1D. R. C. James (University of Oxford)H-Index: 2
#2Frédéric Ris (Geneva College)H-Index: 16
Last. Roel Hompes (University of Oxford)H-Index: 21
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Background and aims Anastomotic dehiscence is one of the most feared complications in colorectal surgery leading to significant morbidity and mortality. Progressively lower anastomoses are associated with a greater leak rate. One of the key factors is the perfusion of the bowel to be joined. Presently, surgeons rely on a variety subjective measures to determine anastomotic perfusion and mechanical integrity however these have shortcomings. The aim of this paper is to appraise the literature on t...
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#1Frédéric Ris (Geneva College)H-Index: 16
#2Nicolas Buchs (Geneva College)H-Index: 29
Last. Roel Hompes (University of Oxford)H-Index: 21
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While still debated, it was advised to perform a protective temporary ileostomy after a low anterior resection (LAR). This might help to decrease the leak rate and therefore offers the patient better outcomes. Anastomotic leak can occur in many situations after a LAR and the control of the risk factors helps to adapt the need of an ileostomy. Near infrared technology allows assessing the microvascularisation of the anastomosis at the time of surgery and therefore might be an important tool to av...
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