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Efficacy of Assessing Intraoperative Bowel Perfusion with Near-Infrared Camera in Laparoscopic Gastric Cancer Surgery

Title
Efficacy of Assessing Intraoperative Bowel Perfusion with Near-Infrared Camera in Laparoscopic Gastric Cancer Surgery
Authors
Huh, Yeon-JuLee, Hyuk-JoonKim, Tae-HanChoi, Yun-suckPark, Ji-HoSon, Young-GilSuh, Yun-SuhkKong, Seong-HoYang, Han-Kwang
Ewha Authors
허연주
Issue Date
2019
Journal Title
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES
ISSN
1092-6429JCR Link

1557-9034JCR Link
Citation
JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES vol. 29, no. 4, pp. 476 - 483
Keywords
indocyanine greenperfusionstomach neoplasmlaparoscopic gastrectomy
Publisher
MARY ANN LIEBERT, INC
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Background: Anastomotic leakage is a severe complication after gastric cancer surgery. Inadequate blood supply is regarded as an important risk factor. The aim of the study was to evaluate the feasibility and usefulness of intraoperative assessment of anastomotic vascular perfusion in gastric cancer surgery using near-infrared (NIR) camera imaging with indocyanine green (ICG)-enhanced fluorescence technique. Materials and Methods: From March 2015 to 2016, 30 patients undergoing laparoscopic gastrectomy for gastric cancer were prospectively evaluated. After completing the anastomosis, 2.5-5.0 mg of ICG was injected via peripheral veins. All anastomoses and resection margins were investigated using NIR camera to assess anastomotic perfusion. The assessment was performed using the adopted perfusion score of fluorescence activity, which ranged from 1 to 5 (1 = no uptake, and 5 = iso-fluorescent to all other segments). Results: Twenty-six distal gastrectomy (20 gastroduodenostomies, 6 gastrojejunostomies), 3 total gastrectomies (TG), and 1 pylorus-preserving gastrectomy were performed. The gap of visualization was 4.1 +/- 3.2 minutes (range, 2-15) after ICG injection. Twenty-three of 30 patients (76.7%) showed technically successful ICG visualization. Among gastroduodenostomies, the average scores for gastric and duodenal sides were 3.5 and 3.7. Among gastrojejunostomies, the average scores for gastric, jejunal, and duodenal stump sides were 3.5, 4.0, and 3.8 (jejunojejunostomy, 3.5). Among TG, the average scores for esophagojejunostomy, duodenal stump, and jejunojejunostomy were 3.7, 4.0, 4.0, and 4.7. One case of leakage occurred in this study. Other complications included fluid collection and stenosis in 1 patient each. Conclusions: This study showed intraoperative ICG angiography using NIR camera is feasible and provides imaging of anastomotic blood flow. Further studies are needed for practice.
DOI
10.1089/lap.2018.0263
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의료원 > 의료원 > Journal papers
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