Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy.
Usefulness of blood supply visualization by indocyanine green fluorescence for reconstruction during esophagectomy.
复制标题
DOI：
10.1007/s10388-011-0291-7
复制
发表时间：
2011-12
期刊：
影响因子：
2.4
通讯作者：
Tsukada, Kazuhiro
中科院分区：
文献类型：
--
作者：
Shimada, Yutaka;Okumura, Tomoyuki;Nagata, Takuya;Sawada, Shigeaki;Matsui, Koshi;Hori, Ryota;Yoshioka, Isaku;Yoshida, Toru;Osada, Ryusuke;Tsukada, Kazuhiro
在食道切除术中，为重建的器官提供充足的血液供应对于食管胃的安全吻合是非常重要的。近年来，吲哚青绿(ICG)已被用于血管外科吻合口血供的可视化。为了可视化重建的血液供应，我们在食道切除术中使用了ICG荧光。自2008年8月以来，40例患者接受了颈或胸段食道切除术。其中胸段食管癌切除33例，颈段食管癌3例，胸颈双重癌4例。在拔除重建的器官之前和之后，以团注的形式注射2.5 mg的ICG。然后用摄像机检测并记录ICG荧光。所有患者在注射后1min均可检测到ICG荧光。血管网在胃壁、结肠移植物和游离空肠移植物中显示良好。在5例患者中，我们还进行了胃短静脉与颈外静脉或颈浅静脉的吻合。除了3例吻合口漏外，所有患者的术中和术后过程都很顺利。ICG荧光可用于评价重建器官的血供，并可用于选择不需要额外血管吻合的患者。然而，吻合口漏并没有减少，因此ICG荧光检测到的微循环并不一定为可行的吻合口提供适当的血液供应。
Adequate blood supply for the reconstructed organ is important for safe esophagogastric anastomosis during esophagectomy. Recently, indocyanine green (ICG) has been used for visualization of the blood supply when anastomosis is performed in vascular surgery. To visualize the blood supply for reconstruction, we employed ICG fluorescence during esophagectomy. From August 2008, 40 patients received cervical or thoracic esophagectomy. They consisted of 33 patients having esophagectomy for thoracic esophageal cancer, 3 being treated for cervical esophageal cancer, and 4 with double cancer of the thoracic and cervical regions. Before and after pulling up the reconstructed organ, 2.5 mg of ICG was injected as a bolus. Then ICG fluorescence was detected by a camera and recorded. ICG fluorescence was easily detected in all patients at 1 min after injection. The vascular network was well visualized in the gastric wall, colonic grafts, and free jejunal grafts. In five patients, we also performed anastomosis between the short gastric vein and the external cervical vein or superficial cervical vein. The intraoperative and postoperative course of all patients was uneventful apart from three anastomotic leakages. ICG fluorescence can be employed to evaluate the blood supply to reconstructed organs and can be useful in selecting the patients who do not need additional vessel anastomosis. However, anastomotic leakage was not reduced, so the microcirculation detected by ICG fluorescence did not necessarily provide appropriate blood supply for a viable anastomosis.
登录
查看更多内容
影响因子：
4.6
作者：
Atkins, BZ;Shah, AS;D'Amico, TA
通讯作者：
D'Amico, TA
影响因子：
9.6
作者：
Michelet, P;D'Journo, XB;Auffray, JP
通讯作者：
Auffray, JP
影响因子：
2.7
作者：
IMAMURA M;OHISHI K;TOBE T
通讯作者：
TOBE T
影响因子：
6
作者：
Ikeda, Y;Niimi, M;Kodaira, S
通讯作者：
Kodaira, S
影响因子：
--
作者：
Kuroiwa, T;Kajimoto, Y;Ohta, T
通讯作者：
Ohta, T