PDF(Pubmed)
Abstract：
Hyperspectral imaging (HSI) is a non-invasive and contactless technique that enables the real-time acquisition of comprehensive information on tissue within the surgical field. In this pilot study, we investigated whether a new HSI system for minimally-invasive surgery, TIVITA® Mini (HSI-MIS), provides reliable insights into tissue perfusion of the proximal and distal esophagogastric anastomotic sites during 21 laparoscopic/thoracoscopic or robotic Ivor Lewis esophagectomies of patients with cancer to minimize the risk of dreaded anastomotic insufficiency. In this pioneering investigation, physiological tissue parameters were derived from HSI measurements of the proximal site of the anastomosis (esophageal stump) and the distal site of the anastomosis (tip of the gastric conduit) during the thoracic phase of the procedure. Tissue oxygenation (StO2), Near Infrared Perfusion Index (NIR-PI), and Tissue Water Index (TWI) showed similar median values at both anastomotic sites. Significant differences were observed only for NIR-PI (median: 76.5 vs. 63.9; p = 0.012) at the distal site (gastric conduit) compared to our previous study using an HSI system for open surgery. For all 21 patients, reliable and informative measurements were attainable, confirming the feasibility of HSI-MIS to assess anastomotic viability. Further studies on the added benefit of this new technique aiming to reduce anastomotic insufficiency are warranted.
摘要：
高光谱成像（HSI）是一种非侵入性和非接触式技术，可实时获取有关手术区域内组织的综合信息。在这项试点研究中，我们调查了新的HSI系统是否用于微创手术，TIVITA®Mini(HSI-MIS),在21例癌症患者的腹腔镜/胸腔镜或机器人IvorLewis食管切除术中，提供了对食管胃吻合部位近端和远端组织灌注的可靠见解，以最大程度地减少可怕的吻合功能不全的风险。在这项开创性的调查中，在手术的胸段阶段，从吻合口的近端部位（食管残端）和吻合口的远端部位（胃导管的尖端）的HSI测量得出生理组织参数。组织氧合(StO2),近红外灌注指数(NIR-PI),和组织水指数（TWI）在两个吻合部位显示相似的中值。仅在NIR-PI中观察到显着差异（中位数：76.5vs.63.9；p=0.012）与我们先前使用HSI系统进行开放手术的研究相比，在远端部位（胃导管）。对于所有21名患者，可靠和翔实的测量是可以实现的，确认HSI-MIS评估吻合口可行性的可行性。有必要对这种旨在减少吻合口功能不全的新技术的附加益处进行进一步研究。
