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首页> 外文期刊>Surgical Endoscopy >Quantitative analysis of colon perfusion pattern using indocyanine green (ICG) angiography in laparoscopic colorectal surgery
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Quantitative analysis of colon perfusion pattern using indocyanine green (ICG) angiography in laparoscopic colorectal surgery

机译：腹腔镜结直肠手术中吲哚菁绿（ICG）血管造影结肠灌注模式的定量分析

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Purpose This study aimed to quantitatively evaluate colon perfusion patterns using indocyanine green (ICG) angiography to find the most reliable predictive factor of anastomotic complications after laparoscopic colorectal surgery. Methods Laparoscopic fluorescence imaging was applied to colorectal cancer patients (n = 86) from July 2015 to December 2017. ICG (0.25 mg/kg) was slowly injected into peripheral blood vessels, and the fluorescence intensity of colonic flow was measured sequentially, producing perfusion graphs using a video analysis and modeling tool. Colon perfusion patterns were categorized as either fast, moderate, or slow based on their fluorescence slope, T_l/2MAX and time ratio (TR = T_1/2MAX/T_MAX). Clinical factors and quantitative perfusion factors were analyzed to identify predictors for anastomotic complications. Results The mean age of patients was 65.4 years, and the male-to-female ratio was 63:23. Their operations were laparoscopic low anterior resection (55 cases) and anterior resection (31 cases). The incidence of anastomotic complication was 7%, including colonic necrosis (n= 1), anastomotic leak (n = 3), delayed pelvic abscess (n= 1), and delayed anastomotic dehiscence (n = 1). Based on quantitative analysis, the fluorescence slope, T_1/2MAX, and TR were related with anastomotic complications. The cut-off value of TR to categorize the perfusion pattern was determined to be 0.6, as shown by ROC curve analysis (AUC 0.929, P < 0.001). Slow perfusion (TR > 0.6) was independent factor for anastomotic complications in a logistic regression model (OR 130.84; 95% CI 6.45-2654.75; P = 0.002). Anastomotic complications were significantly correlated with the novel factor TR (> 0.6) as the most reliable predictor of perfusion and anastomotic complications.Conclusions Quantitative analysis of ICG perfusion patterns using T_1/2max and TR can be applied to detect segments with poor perfusion, thereby reducing anastomotic complications during laparoscopic colorectal surgery.
机译：目的本研究旨在使用吲哚菁绿（ICG）血管造影定量评估结肠灌注模式，以找到腹腔镜结肠直肠手术后吻合吻合症的最可靠的预测因素。方法对2015年7月至2017年12月，将腹腔镜荧光成像应用于结直肠癌患者（n = 86）。将ICG（0.25mg / kg）缓慢注射到外周血血管中，依次测量结肠流动的荧光强度，产生灌注使用视频分析和建模工具的图表。基于它们的荧光斜率，T_L / 2MAX和时间比（TR = T_1 / 2max / T_max），将结肠灌注模式分类为快速，中等或慢。分析了临床因素和定量灌注因子，以确定吻合组并发症的预测因子。结果患者的平均年龄为65.4岁，男性对女性比例为63:23。他们的作用是腹腔镜低前术（55例）和前切除（31例）。吻合吻合症的发生率为7％，包括结肠坏死（n = 1），吻合液泄漏（n = 3），延迟骨盆脓肿（n = 1），延迟吻合裂解（n = 1）。基于定量分析，荧光斜率，T_1 / 2max和TR与吻合口复杂相关。将灌注模式分类的Tr的截止值确定为0.6，如​​ROC曲线分析所示（AUC 0.929，P <0.001）所示。缓慢灌注（TR> 0.6）是逻辑回归模型中吻合吻合症的独立因素（或130.84; 95％CI 6.45-2654.75; p = 0.002）。作为灌注和吻合口的最可靠的预测因子和吻合口复杂性的新型因子Tr（> 0.6）显着相关。结论使用T_1 / 2max和TR的ICG灌注模式的定量分析，可以应用于检测灌注不良的段，从而减少腹腔镜结直肠手术期间的吻合症并发症。

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