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Abstract：
OBJECTIVE: One relevant aspect for anastomotic leakage in colorectal surgery is blood perfusion of both ends of the anastomosis. The clinical evaluation of this issue is limited, but new methods like fluorescence angiography with indocyanine green or non-invasive and contactless hyperspectral imaging have evolved as objective parameters for perfusion evaluation.
METHODS: In this prospective, non-randomized, open-label and two-arm study, fluorescence angiography and hyperspectral imaging were compared in 32 consecutive patients with each other and with the clinical assessment by the surgeon. After preparation of the bowel and determination of the surgical resection line, the tissue was evaluated with hyperspectral imaging for 5 min before and after cutting the marginal artery and assessed by 6 hyperspectral pictures followed by fluorescence angiography with indocyanine green.
RESULTS: In 30 of 32 patients, the image data could be evaluated and compared. Both methods provided a comparable borderline between well-perfused and poorly perfused tissue (p = 0.704). In 15 cases, the surgical resection line was shifted to the central position due to the imaging. The border zone was sharper in fluorescence angiography and best assessed 31 s after injection. With hyperspectral imaging, the border zone was visualized wider and with more differences between proximal and distal border.
CONCLUSIONS: Hyperspectral imaging and fluorescence angiography provide similar results in determining the perfusion border. Both methods allow a good and safe visualization of the blood perfusion at the central resection margin to create a well-perfused anastomosis.
BACKGROUND: This study was registered at Clinicaltrials.gov ( NCT04226781 ) on January 13, 2020.
METHODS: In this prospective, non-randomized, open-label and two-arm study, fluorescence angiography and hyperspectral imaging were compared in 32 consecutive patients with each other and with the clinical assessment by the surgeon. After preparation of the bowel and determination of the surgical resection line, the tissue was evaluated with hyperspectral imaging for 5 min before and after cutting the marginal artery and assessed by 6 hyperspectral pictures followed by fluorescence angiography with indocyanine green.
RESULTS: In 30 of 32 patients, the image data could be evaluated and compared. Both methods provided a comparable borderline between well-perfused and poorly perfused tissue (p = 0.704). In 15 cases, the surgical resection line was shifted to the central position due to the imaging. The border zone was sharper in fluorescence angiography and best assessed 31 s after injection. With hyperspectral imaging, the border zone was visualized wider and with more differences between proximal and distal border.
CONCLUSIONS: Hyperspectral imaging and fluorescence angiography provide similar results in determining the perfusion border. Both methods allow a good and safe visualization of the blood perfusion at the central resection margin to create a well-perfused anastomosis.
BACKGROUND: This study was registered at Clinicaltrials.gov ( NCT04226781 ) on January 13, 2020.
摘要：
目的：结直肠手术吻合口瘘的一个相关方面是吻合口两端的血液灌注。对这个问题的临床评估是有限的，但是像吲哚菁绿荧光血管造影或非侵入性和非接触式高光谱成像这样的新方法已经发展成为灌注评估的客观参数。
方法：在此前瞻性中，非随机化，开放标签和双臂研究，对32例连续患者的荧光血管造影和高光谱成像进行了比较，并与外科医生的临床评估进行了比较。在准备肠道和确定手术切除线后，在切开边缘动脉之前和之后,用高光谱成像5分钟对组织进行评估,并通过6张高光谱照片进行评估,然后用吲哚菁绿进行荧光血管造影.
结果：在32例患者中，有30例，可以评估和比较图像数据。两种方法在灌注良好和灌注不良的组织之间提供了可比的边界线（p=0.704）。在15个案例中，由于影像学检查,手术切除线移至中央位置.在荧光血管造影术中，边界区域更清晰，在注射后31s评估最佳。有了高光谱成像,边界区更宽,近端和远端边界之间的差异更大.
结论：高光谱成像和荧光血管造影在确定灌注边界方面提供了相似的结果。两种方法都可以对中央切除边缘的血液灌注进行良好且安全的可视化，以创建灌注良好的吻合。
背景：这项研究于2020年1月13日在Clinicaltrials.gov（NCT04226781）注册。
方法：在此前瞻性中，非随机化，开放标签和双臂研究，对32例连续患者的荧光血管造影和高光谱成像进行了比较，并与外科医生的临床评估进行了比较。在准备肠道和确定手术切除线后，在切开边缘动脉之前和之后,用高光谱成像5分钟对组织进行评估,并通过6张高光谱照片进行评估,然后用吲哚菁绿进行荧光血管造影.
结果：在32例患者中，有30例，可以评估和比较图像数据。两种方法在灌注良好和灌注不良的组织之间提供了可比的边界线（p=0.704）。在15个案例中，由于影像学检查,手术切除线移至中央位置.在荧光血管造影术中，边界区域更清晰，在注射后31s评估最佳。有了高光谱成像,边界区更宽,近端和远端边界之间的差异更大.
结论：高光谱成像和荧光血管造影在确定灌注边界方面提供了相似的结果。两种方法都可以对中央切除边缘的血液灌注进行良好且安全的可视化，以创建灌注良好的吻合。
背景：这项研究于2020年1月13日在Clinicaltrials.gov（NCT04226781）注册。
