Yeon-Ju Huh1,2, Hyuk-Joon Lee1,3, Tae-Han Kim1,4, Yun-Suck Choi1, Ji-Ho Park1,5, Young-Gil Son1,6, Yun-Suhk Suh1, Seong-Ho Kong1, Han-Kwang Yang1,3. 1. 1 Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea. 2. 2 Department of Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea. 3. 3 Cancer Research Institute, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea. 4. 4 Department of Surgery, Gyeongsang National University Hospital, Changwon, Korea. 5. 5 Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea. 6. 6 Department of Surgery, Keimyung University Dongsan Hospital, Daegu, Korea.
Abstract
BACKGROUND: Anastomotic leakage is a severe complication after gastric cancer surgery. Inadequate blood supply is regarded as an important risk factor. The aim of the study was to evaluate the feasibility and usefulness of intraoperative assessment of anastomotic vascular perfusion in gastric cancer surgery using near-infrared (NIR) camera imaging with indocyanine green (ICG)-enhanced fluorescence technique. MATERIALS AND METHODS: From March 2015 to 2016, 30 patients undergoing laparoscopic gastrectomy for gastric cancer were prospectively evaluated. After completing the anastomosis, 2.5-5.0 mg of ICG was injected via peripheral veins. All anastomoses and resection margins were investigated using NIR camera to assess anastomotic perfusion. The assessment was performed using the adopted perfusion score of fluorescence activity, which ranged from 1 to 5 (1 = no uptake, and 5 = iso-fluorescent to all other segments). RESULTS: Twenty-six distal gastrectomy (20 gastroduodenostomies, 6 gastrojejunostomies), 3 total gastrectomies (TG), and 1 pylorus-preserving gastrectomy were performed. The gap of visualization was 4.1 ± 3.2 minutes (range, 2-15) after ICG injection. Twenty-three of 30 patients (76.7%) showed technically successful ICG visualization. Among gastroduodenostomies, the average scores for gastric and duodenal sides were 3.5 and 3.7. Among gastrojejunostomies, the average scores for gastric, jejunal, and duodenal stump sides were 3.5, 4.0, and 3.8 (jejunojejunostomy, 3.5). Among TG, the average scores for esophagojejunostomy, duodenal stump, and jejunojejunostomy were 3.7, 4.0, 4.0, and 4.7. One case of leakage occurred in this study. Other complications included fluid collection and stenosis in 1 patient each. CONCLUSIONS: This study showed intraoperative ICG angiography using NIR camera is feasible and provides imaging of anastomotic blood flow. Further studies are needed for practice.
BACKGROUND:Anastomotic leakage is a severe complication after gastric cancer surgery. Inadequate blood supply is regarded as an important risk factor. The aim of the study was to evaluate the feasibility and usefulness of intraoperative assessment of anastomotic vascular perfusion in gastric cancer surgery using near-infrared (NIR) camera imaging with indocyanine green (ICG)-enhanced fluorescence technique. MATERIALS AND METHODS: From March 2015 to 2016, 30 patients undergoing laparoscopic gastrectomy for gastric cancer were prospectively evaluated. After completing the anastomosis, 2.5-5.0 mg of ICG was injected via peripheral veins. All anastomoses and resection margins were investigated using NIR camera to assess anastomotic perfusion. The assessment was performed using the adopted perfusion score of fluorescence activity, which ranged from 1 to 5 (1 = no uptake, and 5 = iso-fluorescent to all other segments). RESULTS: Twenty-six distal gastrectomy (20 gastroduodenostomies, 6 gastrojejunostomies), 3 total gastrectomies (TG), and 1 pylorus-preserving gastrectomy were performed. The gap of visualization was 4.1 ± 3.2 minutes (range, 2-15) after ICG injection. Twenty-three of 30 patients (76.7%) showed technically successful ICG visualization. Among gastroduodenostomies, the average scores for gastric and duodenal sides were 3.5 and 3.7. Among gastrojejunostomies, the average scores for gastric, jejunal, and duodenal stump sides were 3.5, 4.0, and 3.8 (jejunojejunostomy, 3.5). Among TG, the average scores for esophagojejunostomy, duodenal stump, and jejunojejunostomy were 3.7, 4.0, 4.0, and 4.7. One case of leakage occurred in this study. Other complications included fluid collection and stenosis in 1 patient each. CONCLUSIONS: This study showed intraoperative ICG angiography using NIR camera is feasible and provides imaging of anastomotic blood flow. Further studies are needed for practice.
Authors: Jonathan P Epperlein; Mykhaylo Zayats; Seshu Tirupathi; Sergiy Zhuk; Tigran Tchrakian; Pol Mac Aonghusa; Donal F O'Shea; Niall P Hardy; Jeffrey Dalli; Ronan A Cahill Journal: AMIA Annu Symp Proc Date: 2022-02-21
Authors: Francesco Belia; Alberto Biondi; Annamaria Agnes; Pietro Santocchi; Antonio Laurino; Laura Lorenzon; Roberto Pezzuto; Flavio Tirelli; Lorenzo Ferri; Domenico D'Ugo; Roberto Persiani Journal: Front Surg Date: 2022-06-28
Authors: Jiadi Xing; Kai Xu; Maoxing Liu; Pin Gao; Fei Tan; Zhendan Yao; Nan Zhang; Hong Yang; Chenghai Zhang; Ming Cui; Xiangqian Su Journal: J Int Med Res Date: 2022-08 Impact factor: 1.573
Authors: M D Slooter; M S E Mansvelders; P R Bloemen; S S Gisbertz; W A Bemelman; P J Tanis; R Hompes; M I van Berge Henegouwen; D M de Bruin Journal: BJS Open Date: 2021-03-05