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首页> 外文期刊>Surgical Endoscopy >Does near-infrared (NIR) fluorescence angiography modify operative strategy during emergency procedures?
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Does near-infrared (NIR) fluorescence angiography modify operative strategy during emergency procedures?

机译：近红外（NIR）荧光血管造影在紧急程序期间修改手术策略吗？

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Introduction Bowel viability can be difficult to evaluate during emergency surgery. Near-infrared (NIR) fluorescence angiography allows an intraoperative assessment of organ perfusion during elective surgery and might help to evaluate intestinal perfusion during emergency procedures. The aim of this study was to assess if NIR modified operative strategy during emergency surgery. Materials and methods From July 2014 to December 2015, we prospectively evaluated all consecutive patients, who had NIR assessment during emergency surgery. Primary endpoint was the modification of operative strategy after the assessment with NIR. Secondary endpoints were general post-operative outcomes, including reoperation rate. Results Fifty-six patients were included in the study. Mean age was 64?±?17?years. An exploratory laparoscopy was performed in 39% ( n ?=?22) and an open surgery in 61% of cases ( n ?=?34). Conversion rate to open surgery was 41% ( n ?=?9). 32 patients had a bowel resection. In 32% of the cases ( n ?=?18), the result of the NIR test led to a modification of the operative strategy. Among them, 33% ( n ?=?6) had a larger resection or a resection, which was initially not planned. The other 12 patients (67%) had finally no resection, which was initially thought to be performed. Importantly, none of those patients needed a reoperation for ischemia. Mean time for performing NIR test was 167?s (±?121). Overall reoperation rate was 16.1% ( n ?=?9). Two patients had an anastomotic leak. Eight patients (14.3%) died within the first 30 post-operative days; however, none of them presented a bowel ischemia or an anastomotic leak. Conclusion NIR is an easy and short procedure, which can be performed during emergency surgery to assess bowel perfusion. It may help the surgeon to preserve intestinal length or to define the exact limits of resection. Overall, we report a modification of operative strategy in up to one-third of evaluated patients.
机译：引言在急诊手术期间难以评估肠道生存能力。近红外（NIR）荧光血管造影允许在选修手术期间术中评估器官灌注，并可能有助于评估急诊程序期间的肠灌注。本研究的目的是评估急诊手术期间的NIR修改的操作策略。 2014年7月至2015年12月的材料和方法，我们在急诊手术中进行了NIR评估的所有连续患者进行了评估。主要终点是与NIR评估后的操作策略的修改。次要终点是术后结果一般，包括重组率。结果五十六名患者纳入该研究。平均年龄为64？±17？年。探索性腹腔镜检查在39％（n？= 22）中进行，在61％的情况下进行开放手术（n？= 34）。开放手术的转化率为41％（n？=？9）。 32例患者患有肠切除术。在32％的病例中（n？=？18），NIR测试的结果导致了操作策略的修改。其中，33％（n？=β6）具有较大的切除或切除，最初未计划。其他12名患者（67％）最终没有切除，最初被认为是进行的。重要的是，这些患者中没有人需要重新开始缺血。执行NIR测试的平均时间是167？S（±121）。总重组率为16.1％（n？=？9）。两名患者有吻合泄漏。八名患者（14.3％）在操作后的30次后的30次死亡;然而，它们都没有呈现肠缺血或吻合泄漏。结论NIR是一种简单而短的程序，可以在急诊手术期间进行，以评估肠灌注。它可以帮助外科医生保留肠长或定义切除的精确限制。总体而言，我们报告了对评估患者的三分之一的手术策略的修改。

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