Duprée A, von Kroge P H, Izbicki J R, Wipper S H, Mann O
Klinik und Poliklinik für Allgemein‑, Viszeral- und Thoraxchirurgie, Universitätsklinikum Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
Klinik und Poliklinik für Gefäßmedizin, Universitäres Herz- und Gefäßzentrum, Universitätsklinikum Hamburg Eppendorf, Hamburg, Deutschland.
Chirurg. 2019 Nov;90(11):875-879. doi: 10.1007/s00104-019-01021-9.
The incidence of esophageal cancer continues to increase. Despite increasing experience in esophageal surgery and perioperative management, anastomotic leakage remains a frequent and severe complication.
The aim of this article is to demonstrate the current role of fluorescence angiography (FA) with indocyanine green (ICG) in the assessment of esophageal anastomoses. The main focus is on the evaluation of the perfusion situation.
A systematic search was carried out in PubMed and Medline on FA and ICG, especially with respect to current subjective and objective interpretation approaches of FA against the background of own research.
The rate of anastomotic leakage remains high despite modern surgical procedures. Assessment of neoesophageal perfusion with FA can significantly reduce the rate of anastomotic leakage. At present, FA is mostly subjectively applied in small case studies. The study situation is heterogeneous. Randomized studies do not so far exist.
The use of FA with ICG is suitable for evaluation of perfusion of the gastric tube. The implementation is simple and can be standardized. Prospective, randomized trials and objective quantification are needed in the future in order to clarify the potential of the technique.
食管癌的发病率持续上升。尽管食管手术及围手术期管理经验不断增加，但吻合口漏仍是一种常见且严重的并发症。
本文旨在阐述吲哚菁绿（ICG）荧光血管造影（FA）在评估食管吻合口中的当前作用。主要关注灌注情况的评估。
在PubMed和Medline上对FA和ICG进行了系统检索，特别是结合自身研究背景，对FA当前的主观和客观解读方法进行检索。
尽管有现代手术方法，但吻合口漏的发生率仍然很高。用FA评估新食管灌注可显著降低吻合口漏的发生率。目前，FA大多在小型病例研究中主观应用。研究情况各异。目前尚无随机对照研究。
使用ICG进行FA适用于评估胃管灌注。操作简单且可标准化。未来需要进行前瞻性随机试验和客观量化，以明确该技术的潜力。
