Abstract:This study proves that cases without the anastomosis of the marginal artery of the rectosigmoid junction truly exist, using studies in living humans (UMIN000011186).
“…In a study of cadavers, Tonder et al [31] reported that there was no anastomosis in 4.7 % (3/64) at a marginal artery level between the last sigmoid arterial branch and superior rectal artery. Watanabe et al [32] also reported that the anastomosis of the marginal artery around the rectosigmoid junction was absent in 5 % ( [14]. In that study, cases with protective diverting ileostomy were excluded, and ICG fluorescence imaging was not introduced during surgery.…”
ICG fluorescence imaging is useful for determining the transection line in laparoscopic colorectal surgery with DST anastomosis. Anticoagulation therapy and preoperative chemotherapy are important risk factors for poor intestinal perfusion.
“…In a study of cadavers, Tonder et al [31] reported that there was no anastomosis in 4.7 % (3/64) at a marginal artery level between the last sigmoid arterial branch and superior rectal artery. Watanabe et al [32] also reported that the anastomosis of the marginal artery around the rectosigmoid junction was absent in 5 % ( [14]. In that study, cases with protective diverting ileostomy were excluded, and ICG fluorescence imaging was not introduced during surgery.…”
ICG fluorescence imaging is useful for determining the transection line in laparoscopic colorectal surgery with DST anastomosis. Anticoagulation therapy and preoperative chemotherapy are important risk factors for poor intestinal perfusion.
“…2 While some research groups have investigated its use as a far-red fluorophore, 29 the low fluorescence yield and lack of any functional groups for addition of ligands have limited its use in clinical applications. ICG is the only approved fluorophore in the NIR-window and several imagers have been designed and commercially launched to allow ICG guidance in surgery for blood flow assessment, [30][31][32] hepatic function assessment, 33,34 and vessel patency and perfusion evaluation especially in reconstructive 35,36 and bypass surgeries. 37,38 The low tissue autofluorescence in the NIR-wavelengths further simplifies the task of filtering out background signals, and since ICG is the primary reimbursable agent today, almost all imaging device companies have built systems specifically for ICG imaging.…”
“…В настоящий момент мы можем обобщить опуб-ликованные результаты 8 серий клинических наблю-дений (от 3 до 119 пациентов) [23, [26][27][28][29][30][31][32], 3 контроли-руемых исследований [33-35] и 1 проспективного мультицентрового исследования [36]. Частота возник-новения несостоятельности первичного анастомоза варьирует в различных исследованиях и может дости-гать 20 % [5][6][7].…”
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