Intraoperative Thermal Imaging for Evaluating Blood Perfusion During Laparoscopic Colorectal Surgery.
Journal
Surgical laparoscopy, endoscopy & percutaneous techniques
ISSN: 1534-4908
Titre abrégé: Surg Laparosc Endosc Percutan Tech
Pays: United States
ID NLM: 100888751
Informations de publication
Date de publication:
16 12 2020
16 12 2020
Historique:
received:
02
09
2020
accepted:
05
10
2020
pubmed:
22
12
2020
medline:
25
11
2021
entrez:
21
12
2020
Statut:
epublish
Résumé
Anastomotic leakage is a feared complication of anterior resection for rectal cancer. Among the various factors reported to be involved in the occurrence of anastomotic leakage, blood perfusion of the remnant intestine is one of the most important. Recently, the usefulness of evaluating blood perfusion using indocyanine green (ICG) has been reported. We therefore aimed to show that measuring intestinal temperature using thermography is useful for evaluating blood perfusion. The authors also investigated the relation between intestinal temperatures and the ICG fluorescence time (FT). Altogether, 45 patients who underwent laparoscopic anterior resection for rectal cancer between July 2017 and September 2018 were enrolled in this study. ICG FT and intestinal temperature were measured after the mesenteric dissection. The temperature boundary could be easily identified using thermographic images. The temperature of the residual intestinal tract was significantly higher than that of the resected intestinal tract at the planned separation line (29.9 vs. 27.3°C). In addition, there was an inverse correlation between the ICG FT and the temperature of the residual intestine. Intestinal temperature measurement through thermography is a useful new tool for evaluating intestinal blood perfusion.
Sections du résumé
BACKGROUND
Anastomotic leakage is a feared complication of anterior resection for rectal cancer. Among the various factors reported to be involved in the occurrence of anastomotic leakage, blood perfusion of the remnant intestine is one of the most important. Recently, the usefulness of evaluating blood perfusion using indocyanine green (ICG) has been reported. We therefore aimed to show that measuring intestinal temperature using thermography is useful for evaluating blood perfusion. The authors also investigated the relation between intestinal temperatures and the ICG fluorescence time (FT).
MATERIALS AND METHODS
Altogether, 45 patients who underwent laparoscopic anterior resection for rectal cancer between July 2017 and September 2018 were enrolled in this study. ICG FT and intestinal temperature were measured after the mesenteric dissection.
RESULT
The temperature boundary could be easily identified using thermographic images. The temperature of the residual intestinal tract was significantly higher than that of the resected intestinal tract at the planned separation line (29.9 vs. 27.3°C). In addition, there was an inverse correlation between the ICG FT and the temperature of the residual intestine.
CONCLUSION
Intestinal temperature measurement through thermography is a useful new tool for evaluating intestinal blood perfusion.
Identifiants
pubmed: 33347089
doi: 10.1097/SLE.0000000000000893
pii: 00129689-202106000-00001
doi:
Substances chimiques
Indocyanine Green
IX6J1063HV
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
281-284Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
Références
Cong ZJ, Hu LH, Bian ZQ, et al. Systematic review of anastomotic leakage rate according to an international grading system following anterior resection for rectal cancer. PLoS One. 2013;25:e75519.
Park JS, Choi GS, Kim SH, et al. Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision: the korean laparoscopic colorectal surgery study group. Ann Surg. 2013;257:665–671.
Wang S, Liu J, Wang S, et al. Adverse effect of anastomotic leakage on local recurrence and survival after curative anterior resection for rectal cancer: a systematic review and meta-analysis. World J Surg. 2017;44:277–284.
Walker KG, Bell SW, Rickard MJ, et al. Anastomotic leakage is predictive of diminished survival after potentially curative resection for colorectal cancer. Ann Surg. 2004;240:255–259.
Fujita S, Teramoto T, Watanabe M, et al. Anastomotic leakage after colorectal cancer surgery: a risk factor for recurrence and poor prognosis. Jpn J Clin Oncol. 1993;23:299–302.
McDermott FD, Heeney A, Kelly ME, et al. Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks. Br J Surg. 2015;102:462–479.
Vignali A, Gianotti L, Braga M, et al. Altered microperfusion at the rectal stump is predictive for rectal anastomotic leak. Dis Colon Rectum. 2000;43:76–82.
Rutegård M, Rutegård J. Anastomotic leakage in rectal cancer surgery: the role of blood perfusion. World J Gastrointest Surg. 2015;7:289–292.
Wada T, Kawada K, Hoshino N, et al. The effects of intraoperative ICG fluorescence angiography in laparoscopic low anterior resection: a propensity score-matched study. Int J Clin Oncol. 2019;24:394–402.
Blanco-Colino R, Espin-Basany E. Intraoperative use of ICG fluorescence imaging to reduce the risk of anastomotic leakage in colorectal surgery: a systematic review and meta-analysis. Tech Coloproctol. 2018;22:15–23.
Boni L, Fingerhut A, Marzorati A, et al. Indocyanine green fluorescence angiography during laparoscopic low anterior resection: results of a case-matched study. Surg Endosc. 2017;31:1836–1840.
Wada T, Kawada K, Takahashi R, et al. ICG fluorescence imaging for quantitative evaluation of colonic perfusion in laparoscopic colorectal surgery. Surg Endosc. 2017;31:4184–4193.
Higashijima J, Shimada M, Yoshikawa K, et al. Usefulness of blood flow evaluation by indocyanine green fluorescence system in laparoscopic anterior resection. J Med Invest. 2019;66:65–69.
Ambrosetti P, Robert J, Mathey P, et al. Left-sided colon and colorectal anastomoses: Doppler ultrasound as an aid to assess bowel vascularization. A prospective evaluation of 200 consecutive elective cases. Int J Colorectal Dis. 1994;9:211–214.
Boyle NH, Manifold D, Jordan MH, et al. Intraoperative assessment of colonic perfusion using scanning laser Doppler flowmetry during colonic resection. J Am Coll Surg. 2000;191:504–510.
Karliczek A, Benaron DA, Baas PC, et al. Intraoperative assessment of microperfusion with visible light spectroscopy for prediction of anastomotic leakage in colorectal anastomoses. Colorectal Dis. 2010;12:1018–1025.
Kudszus S, Roesel C, Schachtrupp A, et al. Intraoperative laser fluorescence angiography in colorectal surgery: a noninvasive analysis to reduce the rate of anastomotic leakage. Langenbecks Arch Surg. 2010;395:1025–1030.
Just M, Chalopin C, Unger M, et al. Monitoring of microvascular free flaps following oropharyngeal reconstruction using infrared thermography: first clinical experiences. Eur Arch Otorhinolaryngol. 2016;273:2659–2667.
Nishikawa K, Matsudaira H, Suzuki H, et al. Intraoperative thermal imaging in esophageal replacement: its use in the assessment of gastric tube viability. Surg Today. 2006;36:802–806.