Conduit Vascular Evaluation is Associated with Reduction in Anastomotic Leak After Esophagectomy

Campbell, Craig; Reames, Mark K.; Robinson, Myra; Symanowski, James T.; Salo, Jonathan C.

doi:10.1007/s11605-015-2794-3

Cited by 69 publications

(41 citation statements)

References 20 publications

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“…As the introduction of NIR fluorescence imaging, 11 clinical studies reported the use of ICG as a NIR fluorescent agent in evaluation of the esophagogastric anastomosis . One study compared the anastomotic leakage rate in perfusion detection both with and without the use of ICG fluorescence imaging, which resulted in reducing the rate from 20% to 0% . Twenty‐one clinical trials reported the use of ICG as a NIR fluorescence agent with different imaging systems in intraoperative evaluation of colorectal anastomoses .…”

Section: Tissue Perfusionmentioning

confidence: 99%

A practical guide for the use of indocyanine green and methylene blue in fluorescence‐guided abdominal surgery

Manen

Handgraaf

Diana

et al. 2018

Journal of Surgical Oncology

239

178

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Near‐infrared (NIR) fluorescence imaging is gaining clinical acceptance over the last years and has been used for detection of lymph nodes, several tumor types, vital structures and tissue perfusion. This review focuses on NIR fluorescence imaging with indocyanine green and methylene blue for different clinical applications in abdominal surgery with an emphasis on oncology, based on a systematic literature search. Furthermore, practical information on doses, injection times, and intraoperative use are provided.

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Section: Tissue Perfusionmentioning

confidence: 99%

A practical guide for the use of indocyanine green and methylene blue in fluorescence‐guided abdominal surgery

Manen

Handgraaf

Diana

et al. 2018

Journal of Surgical Oncology

239

178

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“…Tissue ischemia, potentially resulting in anastomotic leakage, is thought to be moderated by compromised local perfusion and by generalized vascular disease (indicated by aortic calcification) [11,12,17,18]. The left and right gastric artery, the short gastric arteries, and the left gastroepiploic artery are ligated during mobilization of the stomach, causing the blood supply of the gastric tube to depend exclusively on the right gastroepiploic artery [19].…”

Section: Commentmentioning

confidence: 99%

Aortic Calcification Increases the Risk of Anastomotic Leakage After Ivor-Lewis Esophagectomy

Goense

Rossum

Weijs

et al. 2016

The Annals of Thoracic Surgery

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“…Several pilot studies were published that report promising results of NIRF-based perfusion imaging during EC surgery. [ 17 – 20 ] However, these were feasibility studies, and did not encompass any attempts to calculate physiologically relevant parameters, quantify perfusion, or validate imaging findings by comparison with a criterion standard. [ 17 – 24 ]…”

Section: Introductionmentioning

confidence: 99%

Assessment of graft perfusion and oxygenation for improved outcome in esophageal cancer surgery

Daele

Nieuwenhove²,

Ceelen³

et al. 2018

Medicine

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Introduction:The main cause of anastomotic leakage (AL) is tissue hypoxia, which results from impaired perfusion of the pedicle stomach graft after esophageal reconstruction. Clinical judgment is unreliable in determining graft perfusion. Therefore, an objective, validated, and reproducible method is urgently needed. Near infrared fluorescence perfusion imaging using indocyanine green (ICG) is an emerging and promising modality. This study's objectives are to evaluate the feasibility of quantification of ICG angiography (ICGA) to assess graft perfusion and to validate ICGA by comparison with hemodynamic parameters, blood and tissue expression of hypoxia-induced markers, and tissue mitochondrial respiration rates. And, second, to evaluate its ability to predict AL in patients after minimally invasive esophagectomy (MIE).Methods:Patients (N = 70) with resectable esophageal cancer will be recruited for standard MIE. ICGA will be performed after graft creation and thoracic pull-up. Dynamic digital images will be obtained starting after intravenous bolus administration of ICG. The resulting images will be subjected to curve analysis and to compartmental analysis based on the adiabatic approximation to tissue homogeneity kinetic model. The calculated perfusion parameters will be compared to intraoperative hemodynamic data to evaluate the effects of patient hemodynamics. To verify whether graft perfusion represents tissue oxygenation, ICGA perfusion parameters will be compared with systemic and serosa lactate from the stomach graft. In addition, perfusion parameters will be compared to tissue expression of hypoxia-related markers and mitochondrial chain respiratory rate. Finally, the ability of functional, histological, and cellular perfusion and oxygenation parameters to predict AL and postoperative morbidity in general will be evaluated using the appropriate univariate and multivariate statistical analyses.Discussion:The results of this project may lead to a novel, reproducible, and minimally invasive method to objectively assess perioperative anastomotic perfusion during MIE, potentially reducing the incidence of AL and its associated severe morbidity and mortality.Trial registration:Clinicaltrials.gov registration number is NCT03587532. The study was approved by the ethical committee of the Ghent University, Belgium (B670201836427).

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Conduit Vascular Evaluation is Associated with Reduction in Anastomotic Leak After Esophagectomy

Cited by 69 publications

References 20 publications

A practical guide for the use of indocyanine green and methylene blue in fluorescence‐guided abdominal surgery

A practical guide for the use of indocyanine green and methylene blue in fluorescence‐guided abdominal surgery

Aortic Calcification Increases the Risk of Anastomotic Leakage After Ivor-Lewis Esophagectomy

Assessment of graft perfusion and oxygenation for improved outcome in esophageal cancer surgery

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