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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2022
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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. |
format | Online Article Text |
id | pubmed-10150173 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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