Indocyanine Green Fluorescence Angiography Versus Visual Assessment for Assessing Perfusion of Gastric Conduit and Esophageal Stump in Post Esophagectomy Patients: A Pilot Randomized Controlled Study.

IF 2 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2025-05-14 DOI:10.1002/jso.28145

Subramanyeshwar Rao Thammineedi, Sujit Chyau Patnaik, Pratap Reddy, Ajesh Raj Saksena, Srijan Shukla, Makayla E Schissel, Lynette M Smith, Chandrakanth Are, Syed Nusrath

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引用次数: 0

Abstract

Background and objective: Anastomotic leak (AL) is a serious complication following esophagectomy and is often linked to poor perfusion of the gastric conduit (GC) and esophageal stump (EC). The aim of this study is to compare the efficacy of intraoperative Indocyanine green fluorescence angiography (ICG-FA) versus visual assessment VA) to assess perfusion status and its impact on the rate of AL.

Methods: Fifty-eight esophageal or gastroesophageal junction carcinoma patients were randomized to ICG-FA (28) and VA (30) groups. Perfusion status was assessed with VA alone in the VA group and with VA followed by ICG-FA in the ICG-FA group.

Results: The ICG-FA group had a lower leak rate of 4% when compared to 27% in the VA group (p = 0.03). ICG-FA identified nine cases where VA misjudged the GC tip vascularity, thereby avoiding unnecessary resections. ICG-FA necessitated revision of the GC tip in one case missed by VA and also identified poor perfusion of ES tip in three cases mandating revision which were deemed well-perfused by VA.

Conclusion: ICG-FA demonstrated superiority over VA in assessing perfusion adequacy of the GC and ES, which resulted in a statistically significant decrease in the rate of anastomotic leaks.

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吲哚菁绿荧光血管造影与目测评估食管切除术后胃导管和食管残端灌注：一项随机对照试验研究。

背景与目的：吻合口漏（AL）是食管切除术后的严重并发症，通常与胃导管（GC）和食管残端（EC）灌注不良有关。本研究的目的是比较术中吲哚青绿荧光血管造影（ICG-FA）与视觉评估VA的疗效，以评估灌注状态及其对al率的影响。方法：58例食管癌或胃食管癌患者随机分为ICG-FA组（28例）和VA组（30例）。VA组单独用VA评估灌注状态，ICG-FA组同时用VA和ICG-FA评估灌注状态。结果：ICG-FA组渗漏率为4%，低于VA组的27% （p = 0.03）。ICG-FA鉴定了9例VA误判了GC尖端血管，从而避免了不必要的切除。1例VA漏诊的GC端需要翻修，3例VA认为灌注良好的ES端需要翻修，ICG-FA发现ES端灌注不良。结论：ICG-FA在评估GC和ES灌注充分性方面优于VA，吻合口漏率显著降低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.