Hennig Sebastian, Jansen-Winkeln Boris, Köhler Hannes, Knospe Luise, Chalopin Claire, Maktabi Marianne, Pfahl Annekatrin, Hoffmann Jana, Kwast Stefan, Gockel Ines, Moulla Yusef
Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Liebigstr. 20, D-04103 Leipzig, Germany.
Department of General, Visceral, Thoracic and Vascular Surgery, St. Georg Hospital, Delitzscher Str. 141, D-04129 Leipzig, Germany.
Cancers (Basel). 2021 Dec 25;14(1):97. doi: 10.3390/cancers14010097.
Novel intraoperative imaging techniques, namely, hyperspectral (HSI) and fluorescence imaging (FI), are promising with respect to reducing severe postoperative complications, thus increasing patient safety. Both tools have already been used to evaluate perfusion of the gastric conduit after esophagectomy and before anastomosis. To our knowledge, this is the first study evaluating both modalities simultaneously during esophagectomy.
In our pilot study, 13 patients, who underwent Ivor Lewis esophagectomy and gastric conduit reconstruction, were analyzed prospectively. HSI and FI were recorded before establishing the anastomosis in order to determine its optimum position.
No anastomotic leak occurred during this pilot study. In five patients, the imaging methods resulted in a more peripheral adaptation of the anastomosis. There were no significant differences between the two imaging tools, and no adverse events due to the imaging methods or indocyanine green (ICG) injection occurred.
Simultaneous intraoperative application of both modalities was feasible and not time consuming. They are complementary with regard to the ideal anastomotic position and may contribute to better surgical outcomes. The impact of their simultaneous application will be proven in consecutive prospective trials with a large patient cohort.
新型术中成像技术，即高光谱成像（HSI）和荧光成像（FI），在减少严重术后并发症从而提高患者安全性方面具有前景。这两种工具已被用于评估食管切除术后和吻合术前胃管道的灌注情况。据我们所知，这是第一项在食管切除术中同时评估这两种模式的研究。
在我们的初步研究中，对13例行Ivor Lewis食管切除术和胃管道重建术的患者进行了前瞻性分析。在建立吻合术前记录HSI和FI，以确定其最佳位置。
在这项初步研究中未发生吻合口漏。在5例患者中，成像方法使吻合口更偏向周边。两种成像工具之间无显著差异，且未发生因成像方法或吲哚菁绿（ICG）注射导致的不良事件。
两种模式在术中同时应用是可行的且不耗时。它们在理想吻合位置方面具有互补性，可能有助于获得更好的手术效果。其同时应用的影响将在后续纳入大量患者队列的前瞻性试验中得到验证。
