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International Journal of Colorectal Disease

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01-03-2015 | Original Article

Evaluation of the intestinal blood flow near the rectosigmoid junction using the indocyanine green fluorescence method in a colorectal cancer surgery

Authors: Jun Watanabe, Mitsuyoshi Ota, Yusuke Suwa, Shinsuke Suzuki, Hirokazu Suwa, Masasi Momiyama, Atsushi Ishibe, Kazuteru Watanabe, Hidenobu Masui, Kaoru Nagahori, Yasushi Ichikawa, Itaru Endo

Published in: International Journal of Colorectal Disease | Issue 3/2015

Abstract

Purpose

It has been reported that some patients do not have an anastomosis of a marginal artery near the rectosigmoid junction, but the frequency of this condition and its clinical significance so far remain unclear. The aim of this study was to evaluate the blood flow at the marginal artery near the rectosigmoid junction.

Methods

From January 2013 to January 2014, we enrolled consecutive patients with a preoperative diagnosis of left-sided colon cancer or rectal cancer who underwent surgery with lymph node dissection. During the operation, the blood flow through the point of origin of the last sigmoid arterial branch, originating from the inferior mesenteric artery, was interrupted, and the rectosigmoid junction was supplied by only the marginal artery. We injected indocyanine green intravenously and observed the blood flow using a near-infrared camera system.

Results

A total of 119 consecutive patients were enrolled in this study. Sixty-eight patients (57.1 %) had a good anastomosis of the marginal artery near the rectosigmoid junction (type A). In 27 patients (22.7 %), a fluorescence border was recognized, but the fluorescence border diminished within 60 s (Type B). In 18 patients (15.1 %), delayed fluorescence was recognized over 60 s (type C), and 6 patients (5.0 %) had no fluorescence at all (type D). A mean length of 14.8 cm was found from the peritoneal reflection to fluorescence border of blood flow.

Conclusions

This study proves that cases without the anastomosis of the marginal artery of the rectosigmoid junction truly exist, using studies in living humans (UMIN000011186).

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Title: Evaluation of the intestinal blood flow near the rectosigmoid junction using the indocyanine green fluorescence method in a colorectal cancer surgery
Authors: Jun Watanabe
Mitsuyoshi Ota
Yusuke Suwa
Shinsuke Suzuki
Hirokazu Suwa
Masasi Momiyama
Atsushi Ishibe
Kazuteru Watanabe
Hidenobu Masui
Kaoru Nagahori
Yasushi Ichikawa
Itaru Endo
Publication date: 01-03-2015
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 3/2015
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-015-2129-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Evaluation of the intestinal blood flow near the rectosigmoid junction using the indocyanine green fluorescence method in a colorectal cancer surgery

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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