Evaluation of Gastric Microcirculation by Laser Speckle Contrast Imaging During Esophagectomy

Ambrus, Rikard; Achiam, Michael Patrick; Secher, Niels H.; Svendsen, Morten Bo Søndergaard; Rünitz, Kim; Siemsen, Mette; Svendsen, Lars Bo

doi:10.1016/j.jamcollsurg.2017.06.003

Cited by 30 publications

(12 citation statements)

References 43 publications

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“…87 Several groups have measured microvascular blood flow during esophagectomies in humans. [88][89][90] The first group to image the gastric microvascular perfusion was able to detect ischemic areas on gastric tube reconstructions. 90 Interestingly, this study confirms that LSCI can be of help in identifying ischemic areas to reduce anastomotic leakage, which is a major complication within gastrointestinal surgery.…”

Section: Gastro-intestinal Tract Surgerymentioning

confidence: 99%

“…[91][92][93] This was later confirmed by others in Ivor-Lewis esophagectomies. 88 In a different study, LSCI was used to investigate the effect of thoracic epidural anesthesia, which can provoke hypotension, 89 proving that LSCI can be used to image the gastric microcirculation in real-time. Next to this, LSCI is sensitive enough to detect even the slightest changes in the gastric microvascular perfusion.…”

Section: Gastro-intestinal Tract Surgerymentioning

confidence: 99%

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Clinical applications of laser speckle contrast imaging: a review

et al. 2019

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When a biological tissue is illuminated with coherent light, an interference pattern will be formed at the detector, the so-called speckle pattern. Laser speckle contrast imaging (LSCI) is a technique based on the dynamic change in this backscattered light as a result of interaction with red blood cells. It can be used to visualize perfusion in various tissues and, even though this technique has been extensively described in the literature, the actual clinical implementation lags behind. We provide an overview of LSCI as a tool to image tissue perfusion. We present a brief introduction to the theory, review clinical studies from various medical fields, and discuss current limitations impeding clinical acceptance.

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Section: Gastro-intestinal Tract Surgerymentioning

confidence: 99%

Section: Gastro-intestinal Tract Surgerymentioning

confidence: 99%

Clinical applications of laser speckle contrast imaging: a review

et al. 2019

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“…LSCI has been widely applied in clinical practice to better quantify the microcirculation perfusion in real time. [30][31][32][33] Compared with the traditional assessment methods such as pinprick or cold sensory tests, LSCI measurement was objective, simple, and powerful. Traditional block assessing methods depend on patients' subjective judgement to the pinprick or cold stimuli, which is not applicable in special patient population (such as elderly patients with preoperative cognitive dysfunction, children, patients with mental problems, and patients who received peripheral nerve block after general anesthesia).…”

Section: Discussionmentioning

confidence: 99%

Predicting successful lumbar plexus block using blood flow index measured by laser speckle contrast imaging

Xiao-hu

et al. 2020

Preprint

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Background: Laser speckle contrast imaging (LSCI) is a powerful optical imaging technique for real-time and dynamic measurement of regional blood flow. The objective of this prospective observational study was to investigate blood flow changes after blockade of lumbar plexus or its three major branches respectively, with LSCI technique. Methods: This study included 47 adult patients scheduled for elective lower limb surgery. For the selective blockade of lumbar plexus, femoral nerve, obturator nerve, and lateral femoral cutaneous nerve, blood flow images and pinprick sensory scores of the blocked lower limb were recorded 5 min pre block and every 5 min for 30 min post block. Blood flow index (BFI) values of toes were calculated by LSCI software. Results: In this study, we have 21 cases of successful lumbar plexus blocks, 2 cases of failed lumbar plexus block, 8 cases of successful femoral nerve blocks, 8 cases of successful obturator nerve blocks, and 8 cases of successful lateral femoral cutaneous nerve blocks. The BFI values of all five toes were significantly increased as early as 5 min after successful lumbar plexus block, whereas no signiﬁcant difference was found in BFI values after failed lumbar plexus block. BFI changes after successful selective blockade of femoral nerve, obturator nerve, or lateral femoral cutaneous nerve were negligible. BFI value of the big toe at 5 min after the successful lumbar plexus block was increased by 2.57 fold compared with the baseline value, which represented the highest increase among five tested toes. BFI value of the big toe at 10 min after lumbar plexus block showed great power to predict block outcome with a sensitivity of 100% and a speciﬁcity of 100%. The optimal cut-off value given by ROC analysis was 22.11 PU. Conclusions: Increased blood flow index measured by laser speckle contrast imaging is a reliable indicator of successful lumbar plexus block, but cannot indicate successful selective blocks of three major branches of the lumbar plexus. BFI value of the big toe at 10 min after lumbar plexus block could well predict block outcome with the cut-off value of 22.11 PU.

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“…Sturesson and associates were one of the first to report the applicability of LSCI to measure blood flow of visceral organs in an open-abdomen animal experiment [26]. Subsequently, several authors reported on the use of LSCI in the open-abdomen clinical setting of esophagectomy [20,21]. Zheng et al [22] recently demonstrated the first application of laparoscopic LSCI using a similar preclinical setup in rats and swines.…”

Section: Vascular Occlusion Test On the Human Nail Foldmentioning

confidence: 99%

“…This method should be suitable for laparoscopic use, robust and preferably noninvasive. Current techniques that are applied during a surgical procedure to analyze the state of microcirculation are laser Doppler flowmetry (LDF) [15,16], indocyanine green imaging (ICG) [17,18], laser speckle contrast imaging (LSCI) in open- [19][20][21] and, more recently, laparoscopic-surgery [22]. Others have already proven that insight in the state of microcirculation decreases the rate of anastomotic leakage [11,17].…”

Section: Introductionmentioning

confidence: 99%

Application of laser speckle contrast imaging in laparoscopic surgery

Heeman¹,

Dijkstra²,

Hoff³

et al. 2019

Biomed. Opt. Express

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Anastomotic leakage is a worldwide problem in gastrointestinal surgery which seems to be related to the state of microcirculation. Laser speckle contrast imaging (LSCI) could give surgeons insight in the state of microcirculation to attune the site of anastomosis. This work studies the feasibility of LSCI as a tool for this purpose. An experimental setup was developed using a commercially available laparoscopic video system. Laser speckle contrast imaging is capable of detecting ischemic areas on the large intestine. Further research and development are required before adaptation of this technique in the operating room.

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Evaluation of Gastric Microcirculation by Laser Speckle Contrast Imaging During Esophagectomy

Cited by 30 publications

References 43 publications

Clinical applications of laser speckle contrast imaging: a review

Clinical applications of laser speckle contrast imaging: a review

Predicting successful lumbar plexus block using blood flow index measured by laser speckle contrast imaging

Application of laser speckle contrast imaging in laparoscopic surgery

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