Dynamic Serosal Perfusion Assessment during Colorectal Resection Using Visible Light Spectroscopy

Gräfitsch, Alexander; Kirchhoff, Philipp; Soysal, Savas D.; Däster, Silvio; Hoffmann, Henry

doi:10.1159/000514921

Cited by 8 publications

(7 citation statements)

References 24 publications

(32 reference statements)

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“…Recently, several techniques, such as oxygen spectrometry, laser speckle imaging, thermography, and handheld vital microscopy, have been developed to evaluate intestinal perfusion [23][24][25][26]. However, these techniques are not yet widely used due to their high cost and technical complexity.…”

Section: Discussionmentioning

confidence: 99%

Indocyanine green fluorescence imaging during laparoscopic rectal cancer surgery could reduce the incidence of anastomotic leakage: A single institutional retrospective cohort study

Kondo

Kumamoto

Asano

et al. 2022

Preprint

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Background: There is insufficient evidence on whether indocyanine green (ICG) fluorescence angiography can reduce the incidence of anastomotic leakage (AL). This retrospective cohort study aimed to evaluate the effect of ICG fluorescence angiography on AL rates in laparoscopic rectal cancer surgery at a single institution.Methods: Patients who underwent laparoscopic low anterior resection or intersphincteric resection with ICG fluorescence angiography (ICG group; n=73) and patients who underwent a similar surgical procedure for rectal cancer without ICG fluorescence (non-ICG group; n=114) were enrolled consecutively in this study. ICG fluorescence angiography was performed prior to transection of the proximal colon, and anastomosis was performed with sufficient perfusion using ICG fluorescence imaging. AL incidence was compared between both groups, and the risk factors for AL were analyzed. Results: AL occurred in 3 (4.1%) and 14 (12.3%) patients in the ICG and non-ICG groups, respectively. In the ICG group, the median perfusion time from ICG injection was 34 s, and 5 patients (6.8%) required revision of the proximal transection line. None of the patients requiring revision of the proximal transection line developed AL. In the univariate analysis, longer operating time (odds ratio: 2.758; 95% confidence interval: 1.023–7.624) and no implementation of ICG fluorescence angiography (odds ratio: 3.266; 95% confidence interval: 1.038–11.793) were significant factors associated with AL incidence, although the creation of a diverting stoma or insertion of a transanal tube was insignificant.Conclusion: ICG fluorescence angiography was associated with a significant reduction in AL during laparoscopic rectal cancer surgery. Changes in the surgical plan due to ICG fluorescence visibility may help improve the short-term outcomes of patients with rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Indocyanine green fluorescence imaging during laparoscopic rectal cancer surgery could reduce the incidence of anastomotic leakage: A single institutional retrospective cohort study

Kondo

Kumamoto

Asano

et al. 2022

Preprint

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show abstract

“…Karliczek et al reported that the clinical judgment of surgeons appeared to have low sensitivity and specificity in predicting anastomotic leakage in colorectal anastomoses [22]. Recently, several techniques, such as oxygen spectrometry, laser speckle imaging, thermography, and handheld vital microscopy, have been developed to evaluate intestinal perfusion [23][24][25][26]. However, these techniques are not yet widely used due to their high cost and technical complexity.…”

Section: Discussionmentioning

confidence: 99%

Indocyanine green fluorescence imaging during laparoscopic rectal cancer surgery could reduce the incidence of anastomotic leakage: a single institutional retrospective cohort study

et al. 2022

View full text Add to dashboard Cite

Background There is insufficient evidence on whether indocyanine green (ICG) fluorescence angiography can reduce the incidence of anastomotic leakage (AL). This retrospective cohort study aimed to evaluate the effect of ICG fluorescence angiography on AL rates in laparoscopic rectal cancer surgery at a single institution. Methods Patients who underwent laparoscopic low anterior resection or intersphincteric resection with ICG fluorescence angiography (ICG group; n = 73) and patients who underwent a similar surgical procedure for rectal cancer without ICG fluorescence (non-ICG group; n = 114) were enrolled consecutively in this study. ICG fluorescence angiography was performed prior to transection of the proximal colon, and anastomosis was performed with sufficient perfusion using ICG fluorescence imaging. AL incidence was compared between both groups, and the risk factors for AL were analyzed. Results AL occurred in 3 (4.1%) and 14 (12.3%) patients in the ICG and non-ICG groups, respectively. In the ICG group, the median perfusion time from ICG injection was 34 s, and 5 patients (6.8%) required revision of the proximal transection line. None of the patients requiring revision of the proximal transection line developed AL. In univariate analysis, longer operating time (odds ratio: 2.758; 95% confidence interval: 1.023–7.624) and no implementation of ICG fluorescence angiography (odds ratio: 3.266; 95% confidence interval: 1.038–11.793) were significant factors associated with AL incidence, although the creation of a diverting stoma or insertion of a transanal tube was insignificant. Conclusion ICG fluorescence angiography was associated with a significant reduction in AL during laparoscopic rectal cancer surgery. Changes in the surgical plan due to ICG fluorescence visibility may help improve the short-term outcomes of patients with rectal cancer.

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“…Grafitsch [40] explored visible light spectroscopy (VLS) to evaluate serosal oxygen saturation patterns during colorectal resections. The employed materials and methods included the use of VLS on the colonic serosa and evaluation of the bowel perfusion of patients undergoing left-sided colorectal resections at various times during surgery.…”

Section: Recto-colonic Perfusionmentioning

confidence: 99%

Indocyanine Green(Icg) And Colorectal Surgery: A Literature Review on Qualitative and Quantitative Methods of Usage

Simion¹,

Ionescu²,

Chitoran³

et al. 2023

Preprint

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Background: This literature review investigates qualitative and quantitative uses of indocyanine green (ICG) in surgical treatment, as this novel technique has become increasingly popular in ORs (operating rooms) worldwide due to its many advantages. Method: An extensive literature review was performed by searching for relevant terms in 5 international databases (www.pubmed.gov, www.sciencedirect.com, www.scopus.com, www.Oxfordjournals.com, www.reaxys.com). The results of this search were summarized into the main advantages of employing ICG in colorectal surgery as follows: a) intraoperative fluorescence angiography capability; b) fluorescence-guided identification of lymph node involvement in colorectal cancer and the sentinel lymph node method; c) positive fluorescence flagging of a liver tumour as small as "only" 200 tumour cells; d) facilitation of fistula diagnosis; and e) tumour tattooing. Moreover, in addition to qualitative intraoperative ICG use, this technique can be combined with quantitative methods and parameters, such as maximum intensity, relative maximum intensity, and different inflow parameters (time-to-peak, slope, and t1/2max). The conclusion of this article is that fluorescence surgery with ICG aided by near-infrared (NIR) light is a relatively recent technology, an advantage of which is improving the specific anatomic and functional information provided, thus allowing more comprehensive and safer tumour removal as well as preservation of important structures.

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Dynamic Serosal Perfusion Assessment during Colorectal Resection Using Visible Light Spectroscopy

Cited by 8 publications

References 24 publications

Indocyanine green fluorescence imaging during laparoscopic rectal cancer surgery could reduce the incidence of anastomotic leakage: A single institutional retrospective cohort study

Indocyanine green fluorescence imaging during laparoscopic rectal cancer surgery could reduce the incidence of anastomotic leakage: A single institutional retrospective cohort study

Indocyanine green fluorescence imaging during laparoscopic rectal cancer surgery could reduce the incidence of anastomotic leakage: a single institutional retrospective cohort study

Indocyanine Green(Icg) And Colorectal Surgery: A Literature Review on Qualitative and Quantitative Methods of Usage

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