| Autor: |
Hidde A. Galema, Robin A. Faber, Floris P. Tange, Denise E. Hilling, Joost R. van der Vorst, Wobbe O. de Steur, Henk H. Hartgrink, Alexander L. Vahrmeijer, Merlijn Hutteman, J. Sven.D. Mieog, Sjoerd M. Lagarde, Pieter C. van der Sluis, Bas P.L. Wijnhoven, Cornelis Verhoef, Jacobus Burggraaf, Stijn Keereweer |
| Přispěvatelé: |
Otorhinolaryngology and Head and Neck Surgery, Surgery |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
European Journal of Surgical Oncology, 49(5), 990-995. W.B. Saunders |
| ISSN: |
0748-7983 |
| DOI: |
10.1016/j.ejso.2023.02.017 |
| Popis: |
Introduction: Anastomotic leakage is a severe complication after oesophageal resection with gastric conduit reconstruction. Poor perfusion of the gastric conduit plays an important role in the development of anastomotic leakage. Quantitative near-infrared (NIR) fluorescence angiography with indocyanine green (ICG-FA) is an objective technique that can be used for perfusion assessment. This study aims to assess perfusion patterns of the gastric conduit with quantitative ICG-FA. Methods: In this exploratory study, 20 patients undergoing oesophagectomy with gastric conduit reconstruction were included. A standardized NIR ICG-FA video of the gastric conduit was recorded. Postoperatively, the videos were quantified. Primary outcomes were the time-intensity curves and nine perfusion parameters from contiguous regions of interest on the gastric conduit. A secondary outcome was the inter-observer agreement of subjective interpretation of the ICG-FA videos between six surgeons. The inter-observer agreement was tested with an intraclass correlation coefficient (ICC). Results: In a total of 427 curves, three distinct perfusion patterns were recognized: pattern 1 (steep inflow, steep outflow); pattern 2 (steep inflow, minor outflow); and pattern 3 (slow inflow, no outflow). All perfusion parameters were significantly different between the perfusion patterns. The inter-observer agreement was poor – moderate (ICC:0.345,95%CI:0.164–0.584). Discussion: This was the first study to describe perfusion patterns of the complete gastric conduit after oesophagectomy. Three distinct perfusion patterns were observed. The poor inter-observer agreement of the subjective assessment underlines the need for quantification of ICG-FA of the gastric conduit. Further studies should evaluate the predictive value of perfusion patterns and parameters on anastomotic leakage. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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