scholarly journals Single Snapshot Imaging of Optical Properties (SSOP) for Perfusion Assessment during Gastric Conduit Creation for Esophagectomy: An Experimental Study on Pigs

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 6079
Author(s):  
Lorenzo Cinelli ◽  
Eric Felli ◽  
Luca Baratelli ◽  
Silvère Ségaud ◽  
Andrea Baiocchini ◽  
...  
Keyword(s):  
Optical Properties ◽  
Tissue Oxygenation ◽  
Current Knowledge ◽  
New Technology ◽  
Gastric Conduit ◽  
Anastomotic Site ◽  
Optical Technology ◽  
Perfusion Assessment ◽  
Snapshot Imaging ◽  
Single Snapshot

Anastomotic leakage (AL) is a serious complication occurring after esophagectomy. The current knowledge suggests that inadequate intraoperative perfusion in the anastomotic site contributes to an increase in the AL rate. Presently, clinical estimation undertaken by surgeons is not accurate and new technology is necessary to improve the intraoperative assessment of tissue oxygenation. In the present study, we demonstrate the application of a novel optical technology, namely Single Snapshot imaging of Optical Properties (SSOP), used to quantify StO2% in an open surgery experimental gastric conduit (GC) model. After the creation of a gastric conduit, local StO2% was measured with a preclinical SSOP system for 60 min in the antrum (ROI-A), corpus (ROI-C), and fundus (ROI-F). The removed region (ROI-R) acted as ischemic control. ROI-R had statistically significant lower StO2% when compared to all other ROIs at T15, T30, T45, and T60 (p < 0.0001). Local capillary lactates (LCLs) and StO2% correlation was statistically significant (R = −0.8439, 95% CI −0.9367 to −0.6407, p < 0.0001). Finally, SSOP could discriminate resected from perfused regions and ROI-A from ROI-F (the future anastomotic site). In conclusion, SSOP could well be a suitable technology to assess intraoperative perfusion of GC, providing consistent StO2% quantification and ROIs discrimination.

scholarly journals Single snapshot imaging of optical properties

2013 ◽  
Vol 4 (12) ◽  
pp. 2938 ◽  
Author(s):  
Jean Vervandier ◽  
Sylvain Gioux
Keyword(s):  
Optical Properties ◽  
Snapshot Imaging ◽  
Single Snapshot

scholarly journals Real-time, wide-field and high-quality single snapshot imaging of optical properties with profile correction using deep learning

2020 ◽  
Vol 11 (10) ◽  
pp. 5701 ◽  
Author(s):  
Enagnon Aguénounon ◽  
Jason T. Smith ◽  
Mahdi Al-Taher ◽  
Michele Diana ◽  
Xavier Intes ◽  
...  
Keyword(s):  
Optical Properties ◽  
Deep Learning ◽  
Real Time ◽  
Wide Field ◽  
High Quality ◽  
Profile Correction ◽  
Snapshot Imaging ◽  
Single Snapshot

scholarly journals Single snapshot imaging of optical properties using a single-pixel camera: a simulation study

2019 ◽  
Vol 24 (07) ◽  
pp. 1 ◽  
Author(s):  
Enagnon Aguénounon ◽  
Foudil Dadouche ◽  
Wilfried Uhring ◽  
Nicolas Ducros ◽  
Sylvain Gioux
Keyword(s):  
Optical Properties ◽  
Simulation Study ◽  
Snapshot Imaging ◽  
Single Pixel ◽  
Single Snapshot

scholarly journals Quantitative fluorescence-guided perfusion assessment of the gastric conduit to predict anastomotic complications after esophagectomy

2020 ◽  
Author(s):  
M D Slooter ◽  
D M de Bruin ◽  
W J Eshuis ◽  
D P Veelo ◽  
S van Dieren ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Anastomotic Stricture ◽  
Area Under The Curve ◽  
Gastric Conduit ◽  
Fluorescence Angiography ◽  
Anastomotic Site ◽  
Anastomotic Complications ◽  
Risk Patients ◽  
Perfusion Assessment

Summary Background: Fluorescence angiography (FA) assesses anastomotic perfusion during esophagectomy with gastric conduit reconstruction, but its interpretation is subjective. This study evaluated time to fluorescent enhancement in the gastric conduit, with the aim to determine a threshold to predict postoperative anastomotic complications. Methods: In a prospective cohort study, all consecutive patients undergoing esophagectomy with gastric conduit reconstruction from July 2018 to October 2019 were included. FA was performed before anastomotic reconstruction following injection of indocyanine green (ICG). During FA, the following time points were recorded: ICG injection, first fluorescent enhancement in the lung, at the base of the gastric conduit, at the planned anastomotic site, and at ICG watershed or in the tip of the gastric conduit. Anastomotic complications including anastomotic leakage and clinically relevant strictures were documented. Results: Eighty-four patients were included, the majority (67 out of 84, 80%) of which underwent an Ivor Lewis procedure. After a median follow-up of 297 days, anastomotic leakage was observed in 12 out of 84 (14.3%) and anastomotic stricture in 12 out of 82 (14.6%). Time between ICG injection and enhancement in the tip was predictive for anastomotic leakage (P = 0.174, area under the curve = 0.731), and a cut-off value of 98 seconds was derived (specificity: 98%). All times to enhancement at the planned anastomotic site and ICG watershed were significantly predictive for the occurrence of a stricture, however area under the curves were &lt;0.7. Conclusions: The identified fluorescent threshold can be used for intraoperative decision making or to identify potentially high-risk patients for anastomotic leakage after esophagectomy with gastric conduit reconstruction.

scholarly journals Real-time, profile-corrected single snapshot imaging of optical properties

2015 ◽  
Vol 6 (10) ◽  
pp. 4051 ◽  
Author(s):  
Martijn van de Giessen ◽  
Joseph P. Angelo ◽  
Sylvain Gioux
Keyword(s):  
Optical Properties ◽  
Real Time ◽  
Time Profile ◽  
Snapshot Imaging ◽  
Single Snapshot

scholarly journals Optimization of anastomotic technique and gastric conduit perfusion with hyperspectral imaging in an experimental model for minimally invasive esophagectomy

2021 ◽  
Author(s):  
F. Nickel ◽  
A. Studier-Fischer ◽  
B. Özdemir ◽  
J. Odenthal ◽  
L.R. Müller ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hyperspectral Imaging ◽  
Tissue Oxygenation ◽  
Minimally Invasive Esophagectomy ◽  
Gastric Conduit ◽  
Anastomotic Site ◽  
Level Of Evidence ◽  
Anastomotic Technique ◽  
Anastomotic Insufficiency ◽  
Invasive Esophagectomy

AbstractObjectiveTo optimize anastomotic technique and gastric conduit perfusion with hyperspectral imaging (HSI) for total minimally invasive esophagectomy (MIE) with linear stapled anastomosis.Summary Background DataEsophagectomy is the mainstay of esophageal cancer treatment but anastomotic insufficiency related morbidity and mortality remain challenging for patient outcome.MethodsA live porcine model (n=50) for MIE was used with gastric conduit formation and linear stapled side-to-side esophagogastrostomy. Four main experimental groups differed in stapling length (3 vs. 6 cm) and anastomotic position on the conduit (cranial vs. caudal). Tissue oxygenation around the anastomotic site was evaluated using HSI and was validated with histopathology.ResultsThe tissue oxygenation (ΔStO2) after the anastomosis remained constant only for the short stapler in caudal position (−0.4± 4.4%, n.s.) while it dropped markedly in the other groups (short-cranial: -15.6± 11.5%, p=0.0002; long-cranial: -20.4± 7.6%, p=0.0126; long-caudal: -16.1± 9.4%, p<0.0001) Tissue samples from deoxygenated stomach as measured by HSI showed correspondent eosinophilic pre-necrotic changes in 35.7± 9.7% of the surface area.ConclusionsTissue oxygenation at the anastomotic site of the gastric conduit during MIE is influenced by stapling technique. Optimal oxygenation was achieved with a short stapler (3 cm) and sufficient distance of the anastomosis to the cranial end of the gastric conduit. HSI tissue deoxygenation corresponded to histopathologic necrotic tissue changes. These findings allow for optimization of gastric conduit perfusion and anastomotic technique in MIE.Level of EvidenceNot applicable. Translational animal science. Original article.

663 QUANTITATIVE PERFUSION ASSESSMENT TO PREDICT ANASTOMOTIC LEAK AFTER ESOPHAGECTOMY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Yoshitaka Ishikawa ◽  
Christopher Breuler ◽  
Andrew C Chang ◽  
Jules Lin ◽  
Mark B Orringer ◽  
...  
Keyword(s):  
Anastomotic Leak ◽  
Anastomotic Stricture ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Gastric Conduit ◽  
Fluorescence Angiography ◽  
Operative Care ◽  
Significant Difference ◽  
Perfusion Assessment ◽  
Mckeown Esophagectomy

Abstract   Impaired gastric conduit perfusion is a risk factor for anastomotic leak after esophagectomy. Most studies evaluating conduit perfusion have been qualitative with limited impact on post-operative care. The aim of this study is to evaluate the feasibility of intraoperative quantitative assessment of gastric conduit perfusion with indocyanine green (ICG) fluorescence angiography as a predictor for cervical esophagogastric anastomotic (CEGA) leak after esophagectomy. Methods ICG fluorescence angiography using the SPY elite® (Stryker, MI, USA) system was performed in patients who had undergone a transhiatal or McKeown esophagectomy CEGA from July 2015 through December 2020. Fluorescence angiography assessed Ingress (dye uptake) and Egress (dye exit). Ingress Index, Ingress Time, Egress Index, and Egress Time at two anatomic landmarks (tip of the conduit, and 5 cm from tip) were calculated from the measured curve of fluorescence (Figure). The collected data between the leak (L) group and the no-leak (NL) group were compared by both univariate and multivariable analyses to analyze risk factors potentially associated with CEGA leak. Results 304 patients were evaluated. There was no significant difference in patients' demographic and post-operative complications between the groups (L n = 73; NL n = 231), except for anastomotic stricture (42.5 vs 9.1%, p &lt; 0.01). 5 cm and Tip Ingress Index were significantly lower in L (35.0 vs 45.1% and 17.4 vs 25.7%, p &lt; 0.01). 5 cm Ingress Time was significantly higher in L (70.6 vs 56.8 sec, p &lt; 0.01). On multivariable analysis, these variables retained statistical significance, suggesting that these three variables can be used to predict future leak. Conclusion This study revealed that gastric conduit perfusion correlates with the incidence of CEGA leak. Intraoperative measurement of gastric conduit perfusion may be predictive for CEGA leak following esophagectomy. These variables can be easily collected intraoperatively with the SPY study and used to make clinical decisions which may avert CEGA leak.

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