Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstr. 20, D-04103, Leipzig, Germany.
Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Semmelweisstr. 14, D-04103, Leipzig, Germany.
BMC Surg. 2023 Mar 2;23(1):47. doi: 10.1186/s12893-023-01946-3.
Colon conduit is an alternative approach to reconstructing the alimentary tract after esophagectomy. Hyperspectral imaging (HSI) has been demonstrated to be effective for evaluating the perfusion of gastric conduits, but not colon conduits. This is the first study to describe this new tool addressing image-guided surgery and supporting esophageal surgeons to select the optimal colon segment for the conduit and anastomotic site intraoperatively.
Of 10 patients, eight who underwent reconstruction with a long-segment colon conduit after esophagectomy between 01/05/2018 and 01/04/2022 were included in this study. HSI was recorded at the root and tip of the colon conduit after clamping the middle colic vessels, allowing us to evaluate the perfusion and appropriate part of the colon segment.
Anastomotic leak (AL) was detected in only one (12.5%) of all the enrolled patients (n = 8). None of the patients developed conduit necrosis. Only one patient required re-anastomosis on postoperative day 4. No patient needed conduit removal, esophageal diversion, or stent placement. There was a change in the anastomosis site to proximal in two patients intraoperatively. There was no need to change the side of colon conduit intraoperatively in any patient.
HSI is a promising and novel intraoperative imaging tool to objectively assess the perfusion of the colon conduit. It helps the surgeon to define the best perfused anastomosis site and the side of colon conduit in this type of operation.
结肠管是食管切除术后重建消化道的一种替代方法。光谱成像（HSI）已被证明可有效评估胃管的灌注情况，但不能评估结肠管。这是第一项描述这种新工具的研究，用于指导手术并支持食管外科医生在术中选择最佳的结肠段作为管腔和吻合部位。
在 2018 年 5 月 1 日至 2022 年 4 月 1 日期间，8 例接受长段结肠管重建的患者纳入本研究。在夹闭中结肠血管后，对结肠管的根部和尖端进行 HSI 记录，从而评估结肠段的灌注和合适部位。
所有入组患者中仅 1 例（12.5%）发生吻合口漏（AL）（n=8）。无患者发生管腔坏死。仅 1 例患者在术后第 4 天需要再次吻合。无患者需要移除管腔、食管转流或支架置入。2 例患者术中吻合口位置向近端改变。无患者需要术中改变结肠管的侧位。
HSI 是一种有前途的新型术中成像工具，可客观评估结肠管的灌注情况。它有助于外科医生确定此类手术中最佳的吻合部位和结肠管侧位。
