The Role of Intraoperative Hyperspectral Imaging (HSI) in Colon Interposition After Esophagectomy

Overview

Journal BMC Surg

Publisher Biomed Central

Specialty General Surgery

Date 2023 Mar 2

PMID 36864396

Authors

Anne Zimmermann

Hannes Kohler

Claire Chalopin

Boris Jansen-Winkeln

Robert Nowotny

Till Schonherr

Matthias Mehdorn

Konstantin Lukas Uttinger

Rene Thieme

Ines Gockel

Yusef Moulla

Affiliations

Soon will be listed here.

Abstract

Background: 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.

Patients And Methods: 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.

Results: 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.

Conclusion: 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.

Citing Articles

Real-Time Perfusion and Leak Assessment in Bariatric Surgery: Bridging Traditional and Advanced Techniques.

Farah A, Tatakis A, Malshy K, Mahajna A, Sayida S Cureus. 2024; 16(10):e71919.

PMID: 39564049 PMC: 11576053. DOI: 10.7759/cureus.71919.

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