Indocyanine Green Fluorescence Angiography for Quantitative Evaluation of Gastric Tube Perfusion in Patients Undergoing Esophagectomy

Yukaya, Takafumi; Saeki, Hiroshi; Kasagi, Yuta; Nakashima, Yasuhiro; Ando, Koji; Imamura, Yu; Ohgaki, Kippei; Oki, Eiji; Morita, Masaru; Maehara, Yoshihiko

doi:10.1016/j.jamcollsurg.2015.04.022

Cited by 81 publications

(51 citation statements)

References 25 publications

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“…NIR fluorescence imaging‐guided surgery with ICG has been highlighted over the past few years. This technique has been used in many thoracic surgeries such as identification of the segmental border, evaluation of gastric conduit perfusion, detection of bullous lesions, detection of pulmonary nodules and solid tumor tissues, and localization of small pulmonary nodules . To the best of our knowledge, this is the first study to investigate the value of this technique during sympathectomy in the management of PPH.…”

Section: Discussionmentioning

confidence: 99%

The safety and feasibility of intraoperative near‐infrared fluorescence imaging with indocyanine green in thoracoscopic sympathectomy for primary palmar hyperhidrosis

Pei

Liu

et al. 2020

Thoracic Cancer

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Background We investigated the safety and feasibility of intraoperative near‐infrared (NIR) imaging using indocyanine green (ICG) during sympathectomy in the management of primary palmar hyperhidrosis (PPH). Methods We performed a retrospective review of 142 patients (ICG group) who underwent endoscopic thoracic sympathectomy (ETS) between February 2018 and April 2019. All patients received a 5 mg/kg infusion of ICG 24 hours preoperatively. The vital signs before and after ICG injection and adverse reactions were recorded. Meanwhile, 498 patients (Non‐ICG group) who underwent ETS by normal thoracoscopy during August 2017 to April 2019 were also reviewed to compare the abnormal white blood cell (WBC) counts, alanine transaminase (ALT), aspartate transaminase (AST), blood urea nitrogen (BUN), and creatinine (Cr) levels before and after operation between two groups. Results For ICG group, the vital signs including body temperature, heart rate and blood pressure before and after ICG injection were stable. There was no significant difference in the abnormal WBC counts, ALT, AST, BUN, and Cr levels before and after operation between two groups. Only one patient had mild adverse reaction (0.7%) after ICG injection. The visibility rate of all sympathetic ganglions was 96.7% (1369/1415). The visibility rate from T1 to T5 was 98.23% (278/283), 98.23% (278/283), 97.17% (275/283), 95.76% (271/283), and 94.35% (267/283), respectively. There was no significant difference in the visibility rate with regard to age, gender, height, weight, body mass index, and PPH grade. Conclusions NIR fluorescence imaging with ICG for identifying sympathetic ganglions is relatively safe and feasible. Key points • Significant findings of the study. NIR fluorescence imaging with ICG for identifying sympathetic ganglions is relatively safe and feasible. • What this study adds. This technology may take the place of the rib‐oriented method as standard practice for the precise localization of sympathetic ganglions, and may improve the effect of sympathectomies.

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Section: Discussionmentioning

confidence: 99%

The safety and feasibility of intraoperative near‐infrared fluorescence imaging with indocyanine green in thoracoscopic sympathectomy for primary palmar hyperhidrosis

Pei

Liu

et al. 2020

Thoracic Cancer

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“…Recently, indocyanine green fluorescence has been suggested as a technique to facilitate visualization of the haemodynamics in a reconstructed gastric tube during surgery. This could be of interest in patients with CT findings of coeliac axis stenosis or compression, for use in predicting the risk of gastric tube necrosis.…”

Section: Discussionmentioning

confidence: 99%

Preoperative imaging and prediction of oesophageal conduit necrosis after oesophagectomy for cancer

Laïnas

Fuks

Gaujoux

et al. 2017

British Journal of Surgery

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“…We evaluated the flow speed of ICG fluorescence in the gastric conduit wall, in difference to other investigators who have previously assessed the intensity of ICG fluorescence for quantitative analysis. [27,28] When compared with our assessment, their methods may differentiate between inflow impairment and outflow impairment of the gastric conduit wall. In our study, the flow speed of ICG fluorescence in the gastric conduit wall showed no correlation with connection of right and left gastroepiploic arteries and congestion at the tip of the gastric conduit, but had high sensitivity and specificity to predict anastomotic leakage; therefore, our method could evaluate the comprehensive blood flow including the inflow and outflow of the gastric conduit wall.…”

Section: Discussionmentioning

confidence: 99%

Blood flow speed of the gastric conduit assessed by indocyanine green fluorescence

Koyanagi

Ozawa²,

Oguma³

et al. 2016

Medicine

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Anastomotic leakage is considered as an independent risk factor for postoperative mortality after esophagectomy, and an insufficient blood flow in the reconstructed conduit may be a risk factor of anastomotic leakage. We investigated the clinical significance of blood flow visualization by indocyanine green (ICG) fluorescence in the gastric conduit as a means of predicting the leakage of esophagogastric anastomosis after esophagectomy.Forty patients who underwent an esophagectomy with gastric conduit reconstruction were prospectively investigated. ICG fluorescence imaging of the gastric conduit was detected by a near-infrared camera system during esophagectomy and correlated with clinical parameters or surgical outcomes.In 25 patients, the flow speed of ICG fluorescence in the gastric conduit wall was simultaneous with that of the greater curvature vessels (simultaneous group), whereas in 15 patients this was slower than that of the greater curvature vessels (delayed group). The reduced speed of ICG fluorescence stream in the gastric conduit wall was associated with intraoperative blood loss (P = 0.008). Although anastomotic leakage was not found in the simultaneous group, it occurred in 7 patients of the delayed group (P < 0.001). A flow speed of ICG fluorescence in the gastric conduit wall of 1.76 cm/s or less was determined by a receiver operating characteristic (ROC) curve, identified as a significant independent predictor of anastomotic leakage after esophagectomy (P = 0.004).This preliminary study demonstrates that intraoperative evaluation of blood flow speed by ICG fluorescence in the gastric conduit wall is a useful means to predict the risk of anastomotic leakage after esophagectomy.

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Indocyanine Green Fluorescence Angiography for Quantitative Evaluation of Gastric Tube Perfusion in Patients Undergoing Esophagectomy

Cited by 81 publications

References 25 publications

The safety and feasibility of intraoperative near‐infrared fluorescence imaging with indocyanine green in thoracoscopic sympathectomy for primary palmar hyperhidrosis

The safety and feasibility of intraoperative near‐infrared fluorescence imaging with indocyanine green in thoracoscopic sympathectomy for primary palmar hyperhidrosis

Preoperative imaging and prediction of oesophageal conduit necrosis after oesophagectomy for cancer

Blood flow speed of the gastric conduit assessed by indocyanine green fluorescence

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