Rupan Paramasivam, Claudia Jaensch, Anders Husted Madsen, Mai-Britt Worm Ørntoft
{"title":"实时激光散斑造影评价右半结肠切除术术中吻合口微循环安全可行","authors":"Rupan Paramasivam, Claudia Jaensch, Anders Husted Madsen, Mai-Britt Worm Ørntoft","doi":"10.1111/codi.70162","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>Successful anastomotic healing is essential in colorectal surgery and depends on adequate microcirculation at the resection site to prevent anastomotic leakage (AL). Traditionally, surgeons subjectively assess this. Laser speckle contrast imaging (LSCI) provides an objective, dye-free, and non-contact method for measuring the bowel end microcirculation that could perioperatively support the surgeon's assessment. This study aimed to determine the feasibility of LSCI and evaluate surgeons' subjective opinions on its potential to assist in surgical decision-making.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>This feasibility trial was conducted within the IDEAL framework as a non-interventional multicentre study. Patients undergoing elective right hemicolectomy were included. LSCI measurements were conducted twice perioperatively: before and after anastomosis formation. Surgeons were blinded to all measurements. Postoperatively, LSCI images and a questionnaire were presented to the surgeon asking whether these images, if presented perioperatively, would have influenced the selection of the optimal anastomotic site.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>High-quality LSCI measurements were obtained in all 20 patients operated on by 17 different surgeons, with clear and interpretable perfusion images captured without compromising sterility or extending operating time significantly. The device was non-invasive and added an average of 2 minutes to the total operation time. Fifteen of the 17 surgeons indicated that measures could have influenced surgical decision-making. In 50% of the cases, the surgeon reported a change in the resection site, by an average of 1.2 cm, based on LSCI images.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study demonstrated that LSCI effectively displays colonic perfusion in real-time without disrupting the surgical procedure. The potential clinical value of LSCI with additional visual feedback lies in assisting surgeons in selecting the most optimal anastomotic site, thereby potentially improving healing and surgical outcome.</p>\n </section>\n </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 7","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70162","citationCount":"0","resultStr":"{\"title\":\"Intraoperative assessment of anastomotic microcirculation during right hemicolectomy with real-time laser speckle contrast imaging is safe and feasible\",\"authors\":\"Rupan Paramasivam, Claudia Jaensch, Anders Husted Madsen, Mai-Britt Worm Ørntoft\",\"doi\":\"10.1111/codi.70162\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>Successful anastomotic healing is essential in colorectal surgery and depends on adequate microcirculation at the resection site to prevent anastomotic leakage (AL). Traditionally, surgeons subjectively assess this. Laser speckle contrast imaging (LSCI) provides an objective, dye-free, and non-contact method for measuring the bowel end microcirculation that could perioperatively support the surgeon's assessment. This study aimed to determine the feasibility of LSCI and evaluate surgeons' subjective opinions on its potential to assist in surgical decision-making.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Method</h3>\\n \\n <p>This feasibility trial was conducted within the IDEAL framework as a non-interventional multicentre study. Patients undergoing elective right hemicolectomy were included. LSCI measurements were conducted twice perioperatively: before and after anastomosis formation. Surgeons were blinded to all measurements. Postoperatively, LSCI images and a questionnaire were presented to the surgeon asking whether these images, if presented perioperatively, would have influenced the selection of the optimal anastomotic site.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>High-quality LSCI measurements were obtained in all 20 patients operated on by 17 different surgeons, with clear and interpretable perfusion images captured without compromising sterility or extending operating time significantly. The device was non-invasive and added an average of 2 minutes to the total operation time. Fifteen of the 17 surgeons indicated that measures could have influenced surgical decision-making. In 50% of the cases, the surgeon reported a change in the resection site, by an average of 1.2 cm, based on LSCI images.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>This study demonstrated that LSCI effectively displays colonic perfusion in real-time without disrupting the surgical procedure. The potential clinical value of LSCI with additional visual feedback lies in assisting surgeons in selecting the most optimal anastomotic site, thereby potentially improving healing and surgical outcome.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10512,\"journal\":{\"name\":\"Colorectal Disease\",\"volume\":\"27 7\",\"pages\":\"\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-07-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/codi.70162\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Colorectal Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/codi.70162\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Colorectal Disease","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/codi.70162","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Intraoperative assessment of anastomotic microcirculation during right hemicolectomy with real-time laser speckle contrast imaging is safe and feasible
Aim
Successful anastomotic healing is essential in colorectal surgery and depends on adequate microcirculation at the resection site to prevent anastomotic leakage (AL). Traditionally, surgeons subjectively assess this. Laser speckle contrast imaging (LSCI) provides an objective, dye-free, and non-contact method for measuring the bowel end microcirculation that could perioperatively support the surgeon's assessment. This study aimed to determine the feasibility of LSCI and evaluate surgeons' subjective opinions on its potential to assist in surgical decision-making.
Method
This feasibility trial was conducted within the IDEAL framework as a non-interventional multicentre study. Patients undergoing elective right hemicolectomy were included. LSCI measurements were conducted twice perioperatively: before and after anastomosis formation. Surgeons were blinded to all measurements. Postoperatively, LSCI images and a questionnaire were presented to the surgeon asking whether these images, if presented perioperatively, would have influenced the selection of the optimal anastomotic site.
Results
High-quality LSCI measurements were obtained in all 20 patients operated on by 17 different surgeons, with clear and interpretable perfusion images captured without compromising sterility or extending operating time significantly. The device was non-invasive and added an average of 2 minutes to the total operation time. Fifteen of the 17 surgeons indicated that measures could have influenced surgical decision-making. In 50% of the cases, the surgeon reported a change in the resection site, by an average of 1.2 cm, based on LSCI images.
Conclusion
This study demonstrated that LSCI effectively displays colonic perfusion in real-time without disrupting the surgical procedure. The potential clinical value of LSCI with additional visual feedback lies in assisting surgeons in selecting the most optimal anastomotic site, thereby potentially improving healing and surgical outcome.
期刊介绍：
Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate.
Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases.
Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies.
Note that the journal does not usually accept paediatric surgical papers.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
