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Open Access 01-10-2021 | Esophagus Resection | 2020 EAES Oral

Quantitative serosal and mucosal optical imaging perfusion assessment in gastric conduits for esophageal surgery: an experimental study in enhanced reality

Authors: Manuel Barberio, Eric Felli, Margherita Pizzicannella, Vincent Agnus, Mahdi Al-Taher, Emilie Seyller, Yusef Moulla, Boris Jansen-Winkeln, Ines Gockel, Jacques Marescaux, Michele Diana

Published in: Surgical Endoscopy | Issue 10/2021

Abstract

Introduction/objective

Gastric conduit (GC) is used for reconstruction after esophagectomy. Anastomotic leakage (AL) incidence remains high, given the extensive disruption of the gastric circulation. Currently, there is no reliable method to intraoperatively quantify gastric perfusion. Hyperspectral imaging (HSI) has shown its potential to quantify serosal StO₂. Confocal laser endomicroscopy (CLE) allows for automatic mucosal microcirculation quantification as functional capillary density area (FCD-A). The aim of this study was to quantify serosal and mucosal GC’s microperfusion using HSI and CLE. Local capillary lactate (LCL) served as biomarker.

Methods

GC was formed in 5 pigs and serosal StO₂% was quantified at 3 regions of interest (ROI) using HSI: fundus (ROI-F), greater curvature (ROI-C), and pylorus (ROI-P). After intravenous injection of sodium-fluorescein (0.5 g), CLE-based mucosal microperfusion was assessed at the corresponding ROIs, and LCLs were quantified via a lactate analyzer.

Results

StO₂ and FCD-A at ROI-F (41 ± 10.6%, 3.3 ± 3.8, respectively) were significantly lower than ROI-C (68.2 ± 6.7%, p value: 0.005; 18.4 ± 7, p value: 0.01, respectively) and ROI-P (72 ± 10.4%, p value: 0.005; 15.7 ± 3.2 p value: 0.001). LCL value at ROI-F (9.6 ± 4.7 mmol/L) was significantly higher than at ROI-C (2.6 ± 1.2 mmol/L, p value: 0.04) and ROI-P (2.6 ± 1.3 mmol/L, p value: 0.04). No statistically significant difference was found in all metrics between ROI-C and ROI-P. StO₂ correlated with FCD-A (Pearson’s r = 0.67). The LCL correlated negatively with both FCD-A (Spearman’s r = − 0.74) and StO₂ (Spearman’s r = − 0.54).

Conclusions

GC formation causes a drop in serosal and mucosal fundic perfusion. HSI and CLE correlate well and might become useful intraoperative tools.

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Title: Quantitative serosal and mucosal optical imaging perfusion assessment in gastric conduits for esophageal surgery: an experimental study in enhanced reality
Authors: Manuel Barberio
Eric Felli
Margherita Pizzicannella
Vincent Agnus
Mahdi Al-Taher
Emilie Seyller
Yusef Moulla
Boris Jansen-Winkeln
Ines Gockel
Jacques Marescaux
Michele Diana
Publication date: 01-10-2021
Publisher: Springer US
Keywords: Esophagus Resection
Esophagus Resection
Laser
Published in: Surgical Endoscopy / Issue 10/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-08077-3

ACC 2024 Congress

Springer Medicine

Quantitative serosal and mucosal optical imaging perfusion assessment in gastric conduits for esophageal surgery: an experimental study in enhanced reality

Abstract

Introduction/objective

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Introduction/objective

Methods

Results

Conclusions

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