PDF(Pubmed)
Abstract：
UNASSIGNED: Intraoperative indocyanine green fluorescence angiography (ICGFA) perfusion assessment has been demonstrated to reduce complications in reconstructive surgery. This study sought to advance ICGFA flap perfusion assessment via quantification methodologies.
UNASSIGNED: Patients undergoing pedicled and free flap reconstruction were subjected to intraoperative ICGFA flap perfusion assessment using either an open or endoscopic system. Patient demographics, clinical impact of ICGFA and outcomes were documented. From the ICGFA recordings, fluorescence signal quality, as well as inflow/outflow milestones for the flap and surrounding (control) tissue were computationally quantified post hoc and compared on a region of interest (ROI) level. Further software development intended full flap quantification, metric computation and heatmap generation.
UNASSIGNED: Fifteen patients underwent ICGFA assessment at reconstruction (8 head and neck, 6 breast and 1 perineum) including 10 free and 5 pedicled flaps. Visual ICGFA interpretation altered on-table management in 33.3% of cases, with flap edges trimmed in 4 and a re-anastomosis in 1 patient. One patient suffered post-operative flap dehiscence. Laparoscopic camera use proved feasible but recorded a lower quality signal than the open system.Using established and novel metrics, objective ICGFA signal ROI quantification permitted perfusion comparisons between the flap and surrounding tissue. Full flap assessment feasibility was demonstrated by computing all pixels and subsequent outputs summarisation as heatmaps.
UNASSIGNED: This trial demonstrated the feasibility and potential for ICGFA with operator based and quantitative flap perfusion assessment across several reconstructive applications. Further development and implementation of these computational methods requires technique and device standardisation.
UNASSIGNED: Patients undergoing pedicled and free flap reconstruction were subjected to intraoperative ICGFA flap perfusion assessment using either an open or endoscopic system. Patient demographics, clinical impact of ICGFA and outcomes were documented. From the ICGFA recordings, fluorescence signal quality, as well as inflow/outflow milestones for the flap and surrounding (control) tissue were computationally quantified post hoc and compared on a region of interest (ROI) level. Further software development intended full flap quantification, metric computation and heatmap generation.
UNASSIGNED: Fifteen patients underwent ICGFA assessment at reconstruction (8 head and neck, 6 breast and 1 perineum) including 10 free and 5 pedicled flaps. Visual ICGFA interpretation altered on-table management in 33.3% of cases, with flap edges trimmed in 4 and a re-anastomosis in 1 patient. One patient suffered post-operative flap dehiscence. Laparoscopic camera use proved feasible but recorded a lower quality signal than the open system.Using established and novel metrics, objective ICGFA signal ROI quantification permitted perfusion comparisons between the flap and surrounding tissue. Full flap assessment feasibility was demonstrated by computing all pixels and subsequent outputs summarisation as heatmaps.
UNASSIGNED: This trial demonstrated the feasibility and potential for ICGFA with operator based and quantitative flap perfusion assessment across several reconstructive applications. Further development and implementation of these computational methods requires technique and device standardisation.
摘要：
■术中吲哚菁绿荧光血管造影（ICGFA）灌注评估已被证明可以减少重建手术的并发症。本研究旨在通过定量方法推进ICGFA皮瓣灌注评估。
■接受带蒂和游离皮瓣重建的患者使用开放或内窥镜系统进行术中ICGFA皮瓣灌注评估。患者人口统计学，记录ICGFA的临床影响和结局.从ICGFA的录音来看，荧光信号质量,以及皮瓣和周围（对照）组织的流入/流出里程碑进行了事后计算量化，并在感兴趣区域（ROI）水平上进行了比较。进一步的软件开发旨在全瓣量化，度量计算和热图生成。
■15例患者在重建时接受了ICGFA评估（8例头颈部，6个乳房和1个会阴），包括10个游离皮瓣和5个带蒂皮瓣。在33.3%的病例中，视觉ICGFA解释改变了表上管理，4例皮瓣边缘修剪，1例患者再次吻合。一名患者术后皮瓣裂开。腹腔镜相机的使用证明是可行的，但记录的信号质量低于开放系统。使用既定的和新颖的指标，目的ICGFA信号ROI定量允许皮瓣和周围组织之间的灌注比较。通过计算所有像素和随后的输出汇总作为热图，证明了全皮瓣评估的可行性。
■该试验证明了ICGFA在几种重建应用中进行基于操作员和定量皮瓣灌注评估的可行性和潜力。这些计算方法的进一步发展和实施需要技术和设备标准化。
■接受带蒂和游离皮瓣重建的患者使用开放或内窥镜系统进行术中ICGFA皮瓣灌注评估。患者人口统计学，记录ICGFA的临床影响和结局.从ICGFA的录音来看，荧光信号质量,以及皮瓣和周围（对照）组织的流入/流出里程碑进行了事后计算量化，并在感兴趣区域（ROI）水平上进行了比较。进一步的软件开发旨在全瓣量化，度量计算和热图生成。
■15例患者在重建时接受了ICGFA评估（8例头颈部，6个乳房和1个会阴），包括10个游离皮瓣和5个带蒂皮瓣。在33.3%的病例中，视觉ICGFA解释改变了表上管理，4例皮瓣边缘修剪，1例患者再次吻合。一名患者术后皮瓣裂开。腹腔镜相机的使用证明是可行的，但记录的信号质量低于开放系统。使用既定的和新颖的指标，目的ICGFA信号ROI定量允许皮瓣和周围组织之间的灌注比较。通过计算所有像素和随后的输出汇总作为热图，证明了全皮瓣评估的可行性。
■该试验证明了ICGFA在几种重建应用中进行基于操作员和定量皮瓣灌注评估的可行性和潜力。这些计算方法的进一步发展和实施需要技术和设备标准化。
