Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
J Endourol. 2013 Mar;27(3):265-9. doi: 10.1089/end.2012.0207. Epub 2013 Feb 14.
Abstract Background and Purpose: Digital light processing-based hyperspectral imaging (DLP(®)-HSI) was adapted for use during laparoscopic surgery by coupling the spectral illumination source with a conventional laparoscopic light guide and incorporating a customized digital charge-coupled device camera for image acquisition. The system was used to characterize renal oxygenation during robot-assisted laparoscopic partial nephrectomy (RALPN) in humans.
After Institutional Review Board approval, laparoscopic DLP-HSI was performed in consecutive patients undergoing RALPN at our institution. Time trends in relative tissue oxygen saturation (%HbO2) were descriptively analyzed. Associations between %HbO2 and patient age, comorbidities, and estimated glomerular filtration rate (eGFR) were investigated using the Kendall tau test.
Laparoscopic DLP-HSI was performed in 18 patients between May 2011 and February 2012. Median (interquartile range; IQR) age was 55.9 (49-67.5) years. Of the patients, 10/18 (56%) were men and 12/18 (66.7%) had a history of hypertension, diabetes, and/or tobacco use. Median (IQR) %HbO2 before, during, and after ischemia was 60.8% (57.9-68.2%), 53.6% (46.8-55.1%), and 61.5% (54.9-67.6%), respectively. Baseline %HbO2 was inversely associated with preoperative eGFR (τ=-0.38; P=0.036), and eGFR at most recent follow-up (τ=-0.38; P=0.036). Baseline or ischemic %HbO2 did not correlate with hypertension, diabetes, and/or tobacco history. Younger patients (<56 years) had a lower median baseline %HbO2 (P=0.07) and a higher median preoperative eGFR (P=0.038), than their older counterparts.
The laparoscopic HSI system successfully characterized dynamic changes in renal oxygenation during RALPN. Intraoperative laparoscopic HSI outcomes have the potential to predict postoperative individual kidney function.
背景和目的：基于数字光处理的高光谱成像（DLP(®)-HSI）通过将光谱照明源与传统腹腔镜光导耦合，并结合用于图像采集的定制数字电荷耦合器件（CCD）相机，从而适用于腹腔镜手术。该系统用于在我院行机器人辅助腹腔镜部分肾切除术（RALPN）期间对肾脏氧合情况进行特征描述。
经机构审查委员会批准，对在我院行 RALPN 的连续患者实施腹腔镜 DLP-HSI。使用描述性分析方法对相对组织氧饱和度（%HbO2）的时间趋势进行分析。使用 Kendall tau 检验对%HbO2与患者年龄、合并症和估算肾小球滤过率（eGFR）之间的关系进行研究。
2011 年 5 月至 2012 年 2 月，对 18 例患者实施了腹腔镜 DLP-HSI。中位（四分位数范围；IQR）年龄为 55.9（49-67.5）岁。18 例患者中，10/18（56%）为男性，12/18（66.7%）有高血压、糖尿病和/或吸烟史。缺血前、缺血中和缺血后的中位%HbO2分别为 60.8%（57.9-68.2%）、53.6%（46.8-55.1%）和 61.5%（54.9-67.6%）。基线%HbO2与术前 eGFR（τ=-0.38；P=0.036）和最近一次随访时的 eGFR（τ=-0.38；P=0.036）呈负相关。基线或缺血%HbO2与高血压、糖尿病和/或吸烟史无相关性。年龄较小（<56 岁）的患者，其基线中位%HbO2较低（P=0.07），术前中位 eGFR 较高（P=0.038）。
腹腔镜 HSI 系统成功地对 RALPN 期间肾脏氧合的动态变化进行了特征描述。术中腹腔镜 HSI 结果有可能预测术后单个肾脏功能。
