在胸腔镜食管癌切除术中使用吲哚菁绿对胃导管灌注进行评估

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL
SAGE Open Medicine Pub Date : 2024-09-09 eCollection Date: 2024-01-01 DOI:10.1177/20503121241269631
Tiep Nguyen Van, Hoe Nguyen Trong, Son Le Thanh, Khanh Ngo Gia, Hiep Pham Van, Du Nguyen Van, Hoai Nguyen To, Tuan Nguyen Anh
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引用次数: 0

摘要

目的:吲哚菁绿已被用于胸腔镜食管切除术中胃导管灌注的评估,以防止灌注不良引起的吻合口漏。本研究旨在评估在食管癌手术治疗中使用吲哚青绿检测胃导管灌注的初步结果:这项横断面描述性研究针对 54 名接受胸腔镜食管切除术和胃导管重建术的食管癌患者。在完成胃导管重建后,使用红外相机和吲哚菁绿法观察胃导管内的血流情况,以及将胃导管穿过纵隔到达颈部后的血流情况:胃导管的宽度和长度分别为 5.2 ± 0.3 厘米和 31.5 ± 1.6 厘米。从左右胃壁交界处到胃导管远端仍有血管搏动处的胃导管长度为(11.9 ± 4.3)厘米。17名患者(31.5%)的胃导管远端供血不良,吲哚青绿出现时间⩾ 60秒,其中5名患者(9.3%)出现吻合口漏。左右胃静脉血管之间缺乏连接与远端胃导管供血不良有关(p = 0.04)。多变量逻辑回归分析显示,胃导管远端出现吲哚菁绿的时间与吻合口漏的风险有关(OR = 1.99,95% CI = 1.10-3.60,P = 0.02):结论:在胃导管重建中使用吲哚菁绿对胃导管灌注进行调查,发现31.5%的患者导管远端供血不良,其中9.3%出现吻合口漏。胃导管远端(BC 段)的吲哚青绿出现时间越长,吻合口漏的发生率就越高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of the gastric conduit perfusion using indocyanine green in thoracoscopic esophagectomy for esophageal cancer.

Objective: Indocyanine green has been used in the assessment of the gastric conduit perfusion in thoracoscopic esophagectomy to prevent malperfusion-associated anastomotic leak. This study aims to evaluate the initial results of investigating the gastric conduit perfusion with indocyanine green in the surgical treatment of esophageal cancer.

Patients and methods: This cross-sectional descriptive study was carried out on 54 esophageal cancer patients undergoing thoracoscopic esophagectomy and gastric conduit reconstruction. The blood flow in the gastric conduit was observed using an infrared camera and indocyanine green after completion of the conduit and after tunneling the conduit through the mediastinum to the neck.

Results: The gastric conduit width and length were 5.2 ± 0.3 cm, and 31.5 ± 1.6 cm, respectively. The length of the gastric conduit from the junction between the right and left gastroepiploic to the point where the distal end of the gastric conduit still has a vascular pulse was 11.9 ± 4.3 cm. Seventeen patients (31.5%) had poor blood supply at the distal end of the gastric conduit, with indocyanine green appearance time ⩾ 60 s, in whom anastomotic leaks occurred in five patients (9.3%). The lack of connection between the right and left gastroepiploic vessels was associated with poor blood supply of the distal gastric conduit (p = 0.04). Multivariable logistic regression analysis showed association between the time of indocyanine green appearance at the distal gastric conduit and the risk of anastomotic leak (OR = 1.99, 95% CI = 1.10-3.60, p = 0.02).

Conclusion: Investigation of gastric conduit perfusion using indocyanine green in gastric conduit reconstruction detected 31.5% of patients with poor blood supply at the distal end of the conduit, in whom 9.3% had anastomotic leak. The longer indocyanine green appearance time in the distal gastric conduit (segment BC), was associated with the higher rate of the anastomotic leak.

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SAGE Open Medicine
SAGE Open Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
4.30%
发文量
289
审稿时长
12 weeks
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