PDF(Pubmed)
Abstract：
BACKGROUND: Indocyanine green (ICG) fluorescence imaging is widely used in gastrointestinal surgery and is considered useful for reducing anastomotic leakage; however, because ICG remains in the tissue for a certain amount of time, we occasionally must re-evaluate colonic blood flow over a short time period during surgery. Herein, we verify the usefulness of thermography (TG) for evaluating colonic blood flow in a patient who underwent a laparoscopic sigmoidectomy for sigmoid colon cancer.
METHODS: The patient is 43-year-old man who underwent laparoscopic resection of the sigmoid colon for colon cancer. After vascular treatment of the colonic mesentery, ICG/TG identified the boundary between ischemic and non-ischemic colon tissues. An additional 2 cm of colonic mesentery was resected because of the presence of a diverticulum noted at the intended site of oral anastomosis when attaching the anvil head. After additional vascular treatment of the colonic mesentery and administration of ICG, fluorescence was observed in the colon; however, TG identified the zone of the temperature transition on the surface of the colonic mesentery, even after additional colonic mesentery resection in the same region as previously observed. This zone was used as the cut-off line. There were no complications, such as anastomotic leakage, after the surgery.
CONCLUSIONS: Although accumulation of similar cases is necessary, TG has the potential for use as an auxiliary diagnostic tool in clinical practice. TG can depict the presence or absence of blood flow based on surface temperature without the use of imaging agents, and is inexpensive and easy to perform.
METHODS: The patient is 43-year-old man who underwent laparoscopic resection of the sigmoid colon for colon cancer. After vascular treatment of the colonic mesentery, ICG/TG identified the boundary between ischemic and non-ischemic colon tissues. An additional 2 cm of colonic mesentery was resected because of the presence of a diverticulum noted at the intended site of oral anastomosis when attaching the anvil head. After additional vascular treatment of the colonic mesentery and administration of ICG, fluorescence was observed in the colon; however, TG identified the zone of the temperature transition on the surface of the colonic mesentery, even after additional colonic mesentery resection in the same region as previously observed. This zone was used as the cut-off line. There were no complications, such as anastomotic leakage, after the surgery.
CONCLUSIONS: Although accumulation of similar cases is necessary, TG has the potential for use as an auxiliary diagnostic tool in clinical practice. TG can depict the presence or absence of blood flow based on surface temperature without the use of imaging agents, and is inexpensive and easy to perform.
摘要：
背景：吲哚菁绿（ICG）荧光成像广泛用于胃肠道手术，被认为对减少吻合口漏有用；但是，因为ICG在组织中保留了一段时间，我们有时必须在手术过程中短时间内重新评估结肠血流量.在这里，我们验证了热成像(TG)在评估接受腹腔镜乙状结肠癌切除术的患者结肠血流中的有用性.
方法：患者为43岁男性，因结肠癌而接受腹腔镜乙状结肠切除术。结肠肠系膜血管治疗后，ICG/TG确定了缺血性和非缺血性结肠组织之间的边界。由于在连接砧头时在口腔吻合的预期位置处出现憩室，因此切除了另外2厘米的结肠肠系膜。在结肠肠系膜的额外血管治疗和ICG给药后，在结肠中观察到荧光；然而，TG确定了结肠肠系膜表面的温度转变区，即使在与先前观察到的相同区域进行了额外的结肠肠系膜切除术。该区域被用作截止线。没有并发症,如吻合口漏，手术后.
结论：尽管类似病例的积累是必要的，TG具有在临床实践中用作辅助诊断工具的潜力。TG可以在不使用显像剂的情况下根据表面温度描绘血流的存在或不存在，并且价格低廉且易于执行。
方法：患者为43岁男性，因结肠癌而接受腹腔镜乙状结肠切除术。结肠肠系膜血管治疗后，ICG/TG确定了缺血性和非缺血性结肠组织之间的边界。由于在连接砧头时在口腔吻合的预期位置处出现憩室，因此切除了另外2厘米的结肠肠系膜。在结肠肠系膜的额外血管治疗和ICG给药后，在结肠中观察到荧光；然而，TG确定了结肠肠系膜表面的温度转变区，即使在与先前观察到的相同区域进行了额外的结肠肠系膜切除术。该区域被用作截止线。没有并发症,如吻合口漏，手术后.
结论：尽管类似病例的积累是必要的，TG具有在临床实践中用作辅助诊断工具的潜力。TG可以在不使用显像剂的情况下根据表面温度描绘血流的存在或不存在，并且价格低廉且易于执行。
