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The role of fluorescence angiography in colonic interposition after esophagectomy

Colonic interposition is an alternative for gastric conduit reconstruction after esophagectomy. Anastomotic leakage (AL) occurs in 15–25% of patients and may be attributed to reduced blood supply after vascular ligation. Indocyanine green fluorescence angiography (ICG-FA) can visualize tissue perfus...

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Autores principales: Joosten, J J, Gisbertz, S S, Heineman, D J, Daams, F, Eshuis, W J, van Berge Henegouwen, M I
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10150173/
https://www.ncbi.nlm.nih.gov/pubmed/36309805
http://dx.doi.org/10.1093/dote/doac076
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author Joosten, J J
Gisbertz, S S
Heineman, D J
Daams, F
Eshuis, W J
van Berge Henegouwen, M I
author_facet Joosten, J J
Gisbertz, S S
Heineman, D J
Daams, F
Eshuis, W J
van Berge Henegouwen, M I
author_sort Joosten, J J
collection PubMed
description Colonic interposition is an alternative for gastric conduit reconstruction after esophagectomy. Anastomotic leakage (AL) occurs in 15–25% of patients and may be attributed to reduced blood supply after vascular ligation. Indocyanine green fluorescence angiography (ICG-FA) can visualize tissue perfusion. We aimed to give an overview of the first experiences of ICG-FA and AL rate in colonic interposition. This study included all consecutive patients who underwent a colonic interposition between January 2015 and December 2021 at a tertiary referral center. Surgery was performed for the following indications: inability to use the stomach because of previous surgery or extensive tumour involvement, cancer recurrence in the gastric conduit, or because of complications after initial esophagectomy. Since 2018 ICG-FA was performed before anastomotic reconstruction by administration of ICG injection (0.1 mg/kg/bolus), using the Spy-phi (Stryker, Kalamazoo, MI). Twenty-eight patients (9 female, mean age 62.8), underwent colonic interposition of whom 15 (54%) underwent ICG-FA-guided surgery. Within the ICG-FA group, three (20%) AL occurred, whereas in the non-ICG-FA group, three AL and one graft necrosis (31%) occurred (P=0.67). There was a change of management due to the FA assessment in three patients in the FA group (20%) which led to the choice of a different bowel segment for the anastomosis. Mean operative times in the ICG-FA and non-ICG-FA groups were 372±99 and 399±113 minutes, respectively (P=0.85). ICG-FA is a safe, easy and feasible technique to assess perfusion of colonic interpositions. ICG-FA is of added value leading to a change in management in a considerable percentage of patients. Its role in prevention of AL remains to be elucidated.
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spelling pubmed-101501732023-05-02 The role of fluorescence angiography in colonic interposition after esophagectomy Joosten, J J Gisbertz, S S Heineman, D J Daams, F Eshuis, W J van Berge Henegouwen, M I Dis Esophagus Original Article Colonic interposition is an alternative for gastric conduit reconstruction after esophagectomy. Anastomotic leakage (AL) occurs in 15–25% of patients and may be attributed to reduced blood supply after vascular ligation. Indocyanine green fluorescence angiography (ICG-FA) can visualize tissue perfusion. We aimed to give an overview of the first experiences of ICG-FA and AL rate in colonic interposition. This study included all consecutive patients who underwent a colonic interposition between January 2015 and December 2021 at a tertiary referral center. Surgery was performed for the following indications: inability to use the stomach because of previous surgery or extensive tumour involvement, cancer recurrence in the gastric conduit, or because of complications after initial esophagectomy. Since 2018 ICG-FA was performed before anastomotic reconstruction by administration of ICG injection (0.1 mg/kg/bolus), using the Spy-phi (Stryker, Kalamazoo, MI). Twenty-eight patients (9 female, mean age 62.8), underwent colonic interposition of whom 15 (54%) underwent ICG-FA-guided surgery. Within the ICG-FA group, three (20%) AL occurred, whereas in the non-ICG-FA group, three AL and one graft necrosis (31%) occurred (P=0.67). There was a change of management due to the FA assessment in three patients in the FA group (20%) which led to the choice of a different bowel segment for the anastomosis. Mean operative times in the ICG-FA and non-ICG-FA groups were 372±99 and 399±113 minutes, respectively (P=0.85). ICG-FA is a safe, easy and feasible technique to assess perfusion of colonic interpositions. ICG-FA is of added value leading to a change in management in a considerable percentage of patients. Its role in prevention of AL remains to be elucidated. Oxford University Press 2022-10-29 /pmc/articles/PMC10150173/ /pubmed/36309805 http://dx.doi.org/10.1093/dote/doac076 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Joosten, J J
Gisbertz, S S
Heineman, D J
Daams, F
Eshuis, W J
van Berge Henegouwen, M I
The role of fluorescence angiography in colonic interposition after esophagectomy
title The role of fluorescence angiography in colonic interposition after esophagectomy
title_full The role of fluorescence angiography in colonic interposition after esophagectomy
title_fullStr The role of fluorescence angiography in colonic interposition after esophagectomy
title_full_unstemmed The role of fluorescence angiography in colonic interposition after esophagectomy
title_short The role of fluorescence angiography in colonic interposition after esophagectomy
title_sort role of fluorescence angiography in colonic interposition after esophagectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10150173/
https://www.ncbi.nlm.nih.gov/pubmed/36309805
http://dx.doi.org/10.1093/dote/doac076
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