Cinelli Lorenzo, Felli Eric, Baratelli Luca, Ségaud Silvère, Baiocchini Andrea, Okamoto Nariaki, Rodríguez-Luna María Rita, Elmore Ugo, Rosati Riccardo, Partelli Stefano, Marescaux Jacques, Gioux Sylvain, Diana Michele
Department of Gastrointestinal Surgery, San Raffaele Hospital IRCCS, 20132 Milan, Italy.
Research Institute against Digestive Cancer (IRCAD), 67000 Strasbourg, France.
Cancers (Basel). 2021 Dec 2;13(23):6079. doi: 10.3390/cancers13236079.
Anastomotic leakage (AL) is a serious complication occurring after esophagectomy. The current knowledge suggests that inadequate intraoperative perfusion in the anastomotic site contributes to an increase in the AL rate. Presently, clinical estimation undertaken by surgeons is not accurate and new technology is necessary to improve the intraoperative assessment of tissue oxygenation. In the present study, we demonstrate the application of a novel optical technology, namely Single Snapshot imaging of Optical Properties (SSOP), used to quantify StO% in an open surgery experimental gastric conduit (GC) model. After the creation of a gastric conduit, local StO% was measured with a preclinical SSOP system for 60 min in the antrum (ROI-A), corpus (ROI-C), and fundus (ROI-F). The removed region (ROI-R) acted as ischemic control. ROI-R had statistically significant lower StO% when compared to all other ROIs at T15, T30, T45, and T60 ( < 0.0001). Local capillary lactates (LCLs) and StO% correlation was statistically significant (R = -0.8439, 95% CI -0.9367 to -0.6407, < 0.0001). Finally, SSOP could discriminate resected from perfused regions and ROI-A from ROI-F (the future anastomotic site). In conclusion, SSOP could well be a suitable technology to assess intraoperative perfusion of GC, providing consistent StO% quantification and ROIs discrimination.
吻合口漏(AL)是食管切除术后发生的一种严重并发症。目前的认识表明,吻合口术中灌注不足会导致AL发生率增加。目前,外科医生进行的临床评估并不准确,需要新技术来改善术中组织氧合评估。在本研究中,我们展示了一种新型光学技术,即光学特性单快照成像(SSOP)在开放手术实验性胃管(GC)模型中用于量化组织氧饱和度(StO%)的应用。制作胃管后,使用临床前SSOP系统在胃窦(ROI-A)、胃体(ROI-C)和胃底(ROI-F)测量局部StO% 60分钟。切除区域(ROI-R)作为缺血对照。在T15、T30、T45和T60时,ROI-R的StO%与所有其他ROI相比具有统计学显著降低(<0.0001)。局部毛细血管乳酸(LCL)与StO%的相关性具有统计学意义(R = -0.8439,95% CI -0.9367至-0.6407,<0.0001)。最后,SSOP可以区分切除区域和灌注区域,以及ROI-A和ROI-F(未来的吻合口部位)。总之,SSOP很可能是一种评估GC术中灌注的合适技术,可提供一致的StO%量化和ROI区分。