Abstract

In this study, four optical techniques-Optical Coherence Tomography, Sidestream Darkfield Microscopy, Laser Speckle Contrast Imaging, and Fluorescence Angiography (FA)-were compared on performing an intraoperative quantitative perfusion assessment of the gastric conduit during oesophagectomy. We hypothesised that the quantitative parameters show decreased perfusion towards the fundus in the gastric conduit and in patients with anastomotic leakage. In a prospective study in patients undergoing oesophagectomy with gastric conduit reconstruction, measurements were taken with all four optical techniques at four locations from the base towards the fundus in the gastric conduit (Loc1, Loc2, Loc3, Loc4). The primary outcome included 14 quantitative parameters and the anastomotic leakage rate. Imaging was performed in 22 patients during oesophagectomy. Ten out of 14 quantitative parameters significantly indicated a reduced perfusion towards the fundus of the gastric conduit. Anastomotic leakage occurred in 4/22 patients (18.4%). At Loc4, the FA quantitative values for "T1/2" and "mean slope" differed between patients with and without anastomotic leakage (p = 0.025 and p = 0.041, respectively). A quantitative perfusion assessment during oesophagectomy is feasible using optical imaging techniques, of which FA is the most promising for future research.
Original languageEnglish
Article number5522
JournalApplied Sciences (Switzerland)
Volume10
Issue number16
DOIs
Publication statusPublished - 1 Aug 2020

Keywords

  • Esophagectomy
  • Fluorescence angiography
  • Fluorescence imaging
  • Gastric conduit
  • Indocyanine green (ICG)
  • Laser speckle contrast imaging (LSCI)
  • Multispectral
  • Optical coherence tomography (OCT)
  • Optical imaging
  • Sidestream darkfield microscopy (SDF)

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