HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Real-time navigation by fluorescence-based enhanced reality for precise estimation of future anastomotic site in digestive surgery.

AbstractBACKGROUND:
Fluorescence-based enhanced reality (FLER) is a technique to evaluate intestinal perfusion based on the elaboration of the Indocyanine Green fluorescence signal. The aim of the study was to assess FLER's performances in evaluating perfusion in an animal model of long-lasting intestinal ischemia.
MATERIALS AND METHODS:
An ischemic segment was created in 18 small bowel loops in 6 pigs. After 2 h (n = 6), 4 h (n = 6), and 6 h (n = 6), loops were evaluated clinically and by FLER to delineate five regions of interest (ROIs): ischemic zone (ROI 1), presumed viable margins (ROI 2a-2b), and vascularized areas (3a-3b). Capillary lactates were measured to compare clinical vs. FLER assessment. Basal (V 0 ) and maximal (V max) mitochondrial respiration rates were determined according to FLER.
RESULTS:
Lactates (mmol/L) at clinically identified resection lines were significantly higher when compared to those identified by FLER (2.43 ± 0.95 vs. 1.55 ± 0.33 p = 0.02) after 4 h of ischemia. Lactates at 2 h at ROI 1 were 5.45 ± 2.44 vs. 1.9 ± 0.6 (2a-2b; p < 0.0001) vs. 1.2 ± 0.3 (3a-3b; p < 0.0001). At 4 h, lactates were 4.36 ± 1.32 (ROI 1) vs. 1.83 ± 0.81 (2a-2b; p < 0.0001) vs. 1.35 ± 0.67 (3a-3b; p < 0.0001). At 6 h, lactates were 4.16 ± 2.55 vs. 1.8 ± 1.2 vs. 1.45 ± 0.83 at ROI 1 vs. 2a--2b (p = 0.013) vs. 3a-3b (p = 0.0035). Mean V 0 and V max (pmolO2/second/mg of tissue) were significantly impaired after 4 and 6 h at ROI 1 (V 0 (4h) = 34.83 ± 10.39; V max (4h) = 76.6 ± 29.09; V 0 (6h) = 44.1 ± 12.37 and V max (6h) = 116.1 ± 40.1) when compared to 2a--2b (V 0 (4h) = 67.1 ± 17.47 p = 0.00039; V max (4h) = 146.8 ± 55.47 p = 0.0054; V 0 (6h) = 63.9 ± 28.99 p = 0.03; V max (6h) = 167.2 ± 56.96 p = 0.01). V 0 and V max were significantly higher at 3a-3b.
CONCLUSIONS:
FLER may identify the future anastomotic site even after repetitive assessments and long-standing bowel ischemia.
AuthorsMichele Diana, Peter Halvax, Bernard Dallemagne, Yoshihiro Nagao, Pierre Diemunsch, Anne-Laure Charles, Vincent Agnus, Luc Soler, Nicolas Demartines, Veronique Lindner, Bernard Geny, Jacques Marescaux
JournalSurgical endoscopy (Surg Endosc) Vol. 28 Issue 11 Pg. 3108-18 (Nov 2014) ISSN: 1432-2218 [Electronic] Germany
PMID24912446 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Fluorescent Dyes
  • Lactic Acid
  • Indocyanine Green
Topics
  • Anastomosis, Surgical
  • Animals
  • Digestive System Surgical Procedures (methods)
  • Female
  • Fluorescent Dyes
  • Image Interpretation, Computer-Assisted
  • Indocyanine Green
  • Intestine, Small (blood supply)
  • Ischemia (diagnosis)
  • Lactic Acid
  • Male
  • Regression Analysis
  • Spectrometry, Fluorescence (methods)
  • Surgery, Computer-Assisted (methods)
  • Sus scrofa

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: