Indocyanine green perfusion assessment of the gastric conduit in minimally invasive Ivor Lewis esophagectomy

2021 ◽  
Author(s):  
Keouna Pather ◽  
Adeline M. Deladisma ◽  
Christina Guerrier ◽  
Isaac R. Kriley ◽  
Ziad T. Awad
Keyword(s):  
Minimally Invasive ◽  
Indocyanine Green ◽  
Gastric Conduit ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Perfusion Assessment

Near infrared perfusion assessment of gastric conduit during minimally invasive Ivor Lewis esophagectomy

2018 ◽  
Vol 216 (3) ◽  
pp. 524-527 ◽  
Author(s):  
Brian G.A. Dalton ◽  
Abubaker A. Ali ◽  
Marie Crandall ◽  
Ziad T. Awad
Keyword(s):  
Minimally Invasive ◽  
Near Infrared ◽  
Gastric Conduit ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Perfusion Assessment

VS03.05: VASCULAR ASSESSMENT OF THE GASTRIC TUBE IN MINIMALLY INVASIVE IVOR-LEWIS ESOPHAGECTOMY USING INDOCYANINE GREEN

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 48-48
Author(s):  
Dulce Nombre De Maria Momblan ◽  
Victor Turrado-Rodriguez ◽  
Alba Torroella ◽  
Ainitze Ibarzabal ◽  
Arlena Sofia Espinoza ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Indocyanine Green ◽  
Conflicts Of Interest ◽  
Vascular Supply ◽  
Gastric Conduit ◽  
Leak Rate ◽  
Esophagogastric Anastomosis ◽  
Ivor Lewis ◽  
Invasive Esophagectomy ◽  
Ivor Lewis Esophagectomy

Abstract Description One of the major concerns in esophagic surgery is the safety of the esophagogastric anastomosis. Anastomotic leak is associated with important morbidity and mortality. Leak rates have been reported in 4.7% of patients in the Ivor-Lewis procedure and 5.2% for cervical anastomosis. Leak rate has been associated with insufficient vascular supply to the gastric conduit. Indocyanine green (ICG) assessment of the vascularization may be a useful tool to avoid this dreadful complication. Methods A 50-year-old man with medical history of high blood pressure and right pneumothorax was diagnosed of adenocarcinoma of the lower esophagus cT3N3. Neoadjuvant chemo-radiotherapy following CROSS principles was administered. Six weeks after the end of neoadjuvant chemo-radiotherapy a minimally invasive Ivor-Lewis esophagectomy was performed. ICG helped the identification of the right gastroepiploic arcade and of the adequate vascular supply to the gastric conduit. During thoracoscopy, ICG was helpful to assess the vascular supply to the gastric conduit after pull-up into the chest and to check the vascularization of the esophagogastric anastomosis. Results Postoperative evolution was uneventful. Oral intake was resumed on the third postoperative day. Patient was discharged on the 8th postoperative day. Conclusions ICG assessment of the vascularization of the gastric conduit is feasible, safe and helpful in Ivor-Lewis minimally invasive esophagectomy and may decrease the leak rate. Disclosure All authors have declared no conflicts of interest.

PS01.204: ANASTOMOTIC LEAKS AFTER IVOR-LEWIS ESOPHAGECTOMY: INDOCYANINE GREEN NEAR-INFRERED ANGIOGRAPHY FOR GASTRIC CONDUIT BLOOD SUPPLY EVALUATION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 107-107
Author(s):  
Paolo Parise ◽  
Andrea Cossu ◽  
Leonardo Garutti ◽  
Francesco Puccetti ◽  
Ugo Elmore ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Blood Supply ◽  
Near Infrared ◽  
Conflicts Of Interest ◽  
Gastric Conduit ◽  
Smoking History ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Group A ◽  
Group B

Abstract Background Indocyanine Green—Angiography (ICG-A) has been recently introduced for visceral perfusion evaluation. Aim of this study is to assess whether the intraoperative use of ICG-A can improve the evaluation of blood supply of the gastric conduit in Ivor-Lewis esophagectomy for cancer. Methods This is an interim analysis of a prospective interventional study ongoing at our Institution, on 160 Ivor-Lewis esophagectomy patients. After an intravenous bolus of ICG during the abdominal and thoracic stage, the gastric conduit perfusion was evaluated by means of a near infrared ICG-A and graded as ‘well’, ‘hypo-perfused’ or ‘ischemic’. If present, the ischemic or hypo-perfused area was resected. Demographic and clinical parameters and others, such as conduit perfusion speed, intra or post-operative hypotensive episodes have been analyzed. Results Currently 26 patients have been enrolled. An anastomotic leak of any grade was identified in 7 patients. Patients were divided in Group A (7 patients) who developed a leak and Group B (19 patients) who do not. No statistically significant differences were evidenced on demographic and preoperative clinical features, except for higher cigarette smoking history incidence in Group A. Those who developed a leak had an ‘hypo-perfused’ conduit at ICG-A in 71.4% and those who do not in only 15.8% (p 0.014). Median time from ICG injection to appearance of fluorescence at the basis of the gastric conduit was significantly longer in Group A than in Group B, 36 sec. (32–43.5) vs 28 sec. (20–39.8) (p 0.04) but median gastric conduit perfusion speed was similar. Patients in Group B had a higher median width of the conduit than Group A, 5cm (5.0–6.0) vs 4 (4.0–5.0) (p 0.032). Post-operative prolonged hypotensive episodes were seen more frequently in Group A than Group B (p 0.028). No differences were evidenced in terms of fluids infusions, blood loss, conduit length or intraoperative hypotensive episodes. Conclusion Preliminary results seem to show the usefulness of ICG-A in identifying patients at risk of leakage. Nevertheless no reduction of leakage incidence was induced by surgical strategy modification, probably because post-operative events may affect clinical course too. Definitive data have to be awaited. Disclosure All authors have declared no conflicts of interest.

scholarly journals Thoracoscopic management of volvulus of the gastric conduit following minimally invasive Ivor-Lewis esophagectomy

2015 ◽  
Vol 30 (7) ◽  
pp. 3098-3098
Author(s):  
Jeremy Linson ◽  
Michael Latzko ◽  
Bestoun Ahmed ◽  
Ziad Awad
Keyword(s):  
Minimally Invasive ◽  
Gastric Conduit ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy

Robot-Assisted Minimally Invasive Ivor Lewis Esophagectomy With Real-Time Perfusion Assessment

2015 ◽  
Vol 100 (3) ◽  
pp. 947-952 ◽  
Author(s):  
Arielle Hodari ◽  
Ko Un Park ◽  
Brian Lace ◽  
Athanasios Tsiouris ◽  
Zane Hammoud
Keyword(s):  
Minimally Invasive ◽  
Real Time ◽  
Robot Assisted ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Perfusion Assessment
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