Wang Peng, Tian Yantao, Du Yongxing, Zhong Yuxin
Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2024 Jan 18;14:1341900. doi: 10.3389/fonc.2024.1341900. eCollection 2024.
This retrospective study aimed to evaluate the feasibility and safety of intraoperative assessment of anastomotic blood supply in patients undergoing esophagojejunostomy or esophagogastrostomy for gastric cancer using Indocyanine Green Fluorescence Imaging (IGFI).
From January 2019 to October 2021, we conducted a retrospective analysis of patients who had undergone laparoscopic gastrectomy for the treatment of gastric cancer. The patients were consecutively enrolled and categorized into two study groups: the Indocyanine Green Fluorescence Imaging (IGFI) group consisting of 86 patients, and the control group comprising 92 patients. In the IGFI group, intravenous administration of Indocyanine Green (ICG) was performed, and we utilized a fluorescence camera system to assess anastomotic blood supply both before and after the anastomosis.
The demographic characteristics of patients in both groups were found to be comparable. In the IGFI group, the mean time to observe perfusion fluorescence was 26.3 ± 12.0 seconds post-ICG injection, and six patients needed to select a more proximal resection point due to insufficient fluorescence at their initial site of choice. Notably, the IGFI group exhibited a lower incidence of postoperative anastomotic leakage, with no significant disparities observed in terms of pathological outcomes, postoperative recovery, or other postoperative complication rates when compared to the control group (p > 0.05).
This study underscores the potential of IGFI as a dependable and pragmatic tool for the assessment of anastomotic blood supply following esophagojejunostomy or esophagogastrostomy for gastric cancer. The use of IGFI may potentially reduce the occurrence of postoperative anastomotic leakage.
本回顾性研究旨在评估使用吲哚菁绿荧光成像（IGFI）对接受胃癌食管空肠吻合术或食管胃吻合术的患者进行术中吻合口血供评估的可行性和安全性。
2019年1月至2021年10月，我们对接受腹腔镜胃癌切除术的患者进行了回顾性分析。患者连续入组并分为两个研究组：吲哚菁绿荧光成像（IGFI）组，共86例患者；对照组，共92例患者。在IGFI组中，静脉注射吲哚菁绿（ICG），并使用荧光摄像系统在吻合前后评估吻合口血供。
两组患者的人口统计学特征具有可比性。在IGFI组中，注射ICG后观察到灌注荧光的平均时间为26.3±12.0秒，6例患者因初始选择部位荧光不足而需要选择更近端的切除点。值得注意的是，IGFI组术后吻合口漏发生率较低，与对照组相比，在病理结果、术后恢复或其他术后并发症发生率方面无显著差异（p>0.05）。
本研究强调了IGFI作为评估胃癌食管空肠吻合术或食管胃吻合术后吻合口血供的可靠实用工具的潜力。使用IGFI可能会降低术后吻合口漏的发生率。
