Abstract
The HyperEye Medical System is a newly developed device that allows for the visualization of the fluorescent image of indocyanine green enhanced by near-infrared light among the surrounding vivid color images. We recently applied this system to confirm the blood flow of an esophageal substitute, and for sentinel node navigation during esophagectomy. Five consecutive patients with thoracic esophageal cancer who underwent a subtotal esophagectomy between June 2010 and May 2011 were enrolled in the study. The esophageal substitute used for reconstruction was the stomach and ileocecum in four and one cases, respectively. In all cases with a reconstructive stomach, fine arterial blood flow and venous perfusion were observed. The blood flow of the reconstructive colon was poor before microvascular anastomosis, however, it dramatically increased after anastomosis. Concerning the sentinel node navigation, the fluorescence of lymph nodes, lymphatic vessels, and the tumor site were detected. The postoperative courses of all cases were uneventful, with no mortalities or anastomotic leakage occurring.
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References
Handa T, Katare RG, Sasaguri S, Sato T. Preliminary experience for the evaluation of the intraoperative graft patency with real color charge-coupled device camera system: an advanced device for simultaneous capturing of color and near-infrared images during coronary artery bypass graft. Interact Cardiovasc Thorac Surg. 2009;9:150–4.
Handa T, Katare RG, Nishimori H, Wariishi S, Fukutomi T, Yamamoto M, et al. New device for intraoperative graft assessment: Hypereye charge-coupled device camera system. Gen Thorac Cardiovasc Surg. 2010;58:68–77.
Yamauchi K, Nagafuji H, Nakamura T, Sato T, Kohno N. Feasibility of ICG fluorescence-guided sentinel node biopsy in animal models using the HyperEye Medical System. Ann Surg Oncol. 2011;18:2042–7.
Yoshida M, Furukawa T, Morikawa Y, Kitagawa Y, Kitajima M. The developments and achievements of endoscopic surgery, robotic surgery and function-preserving surgery. Jpn J Clin Oncol. 2010;40:863–9.
Yoshida M, Kubota K, Kuroda J, Ohta K, Nakamura T, Saito J, et al. Indocyanine green injection for detecting sentinel nodes using color fluorescence camera in the laparoscopy-assisted gastrectomy. J Gastroenterol Hepatol. 2012;27:29–33.
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A III, editors. AJCC cancer staging manual. 7th ed. New York: Springer; 2009. p. 103–5.
Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO Classification of tumors of the digestive system. 4th ed. Lyon: International Agency for Research on Cancer Publisher; 2010.
Igaki H, Kato H, Ando N, Shinoda M, Shimizu H, Nakamura T, et al. A randomized trial of postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus neoadjuvant chemotherapy for clinical stage II/III squamous cell carcinoma of the thoracic esophagus (JCOG 9907). J Clin Oncol 2008;26 abstr4510.
Kubota K, Mafune K, Yamada K, Yamashita H, Kuroda J, Aikou S, et al. Complete regression of advanced esophageal cancer with abdominal bulky lymph node metastasis treated by concurrent chemoradiotherapy using docetaxel, cisplatin, and 5-fluorouracil. Esophagus. 2009;6:183–7.
Japan Esophageal Society. Japanese classification of esophageal cancer, 10th ed. Esophagus. 2009;6:1–25.
Buise MP, Ince C, Tilanus HW, Klein J, Gommers D, van Bommel J. The effect of nitroglycerin on microvascular perfusion and oxygenation during gastric tube reconstruction. Anesth Analg. 2005;100:1107–11.
Buise M, van Bommel J, Jahn A, Tran K, Tilanus H, Gommers D. Intravenous nitroglycerin does not preserve gastric microcirculation during gastric tube reconstruction: a randomized controlled trial. Crit Care. 2006;10:R131.
Doki Y, Okada K, Miyata H, Yamasaki M, Fujiwara Y, Takiguchi S, et al. Long-term and short-term evaluation of esophageal reconstruction using the colon or the jejunum in esophageal cancer patients after gastrectomy. Dis Esophagus. 2008;21:132–8.
Swisher SG, Hofstetter WL, Miller MJ. The supercharged microvascular jejunal interposition. Semin Thorac Cardiovasc Surg. 2007;19:56–65.
Sekido M, Yamamoto Y, Minakawa H, Sasaki S, Furukawa H, Sugihara T, et al. Variation of microvascular blood flow augmentation—supercharge in esophageal and pharyngeal reconstruction. Rozhl Chir. 2006;85:9–13.
Hirabayashi S, Miyata M, Shoji M, Shibusawa H. Reconstruction of the thoracic esophagus, with extended jejunum used as a substitute, with the aid of microvascular anastomosis. Surgery. 1993;113:515–9.
Sakuraba M, Kimata Y, Hishinuma S, Nishimura M, Gotohda N, Ebihara S. Importance of additional microvascular anastomosis in esophageal reconstruction after salvage esophagectomy. Plast Reconstr Surg. 2004;113:1934–9.
Hoer J, Tons C, Schachtrupp A, Anurov M, Titkova S, Oettinger A, et al. Quantitative evaluation of abdominal wall perfusion after different types of laparotomy closure using laser-fluorescence videography. Hernia. 2002;6:11–6.
Willis S, Holzl F, Krones CJ, Tittel A, Schumpelick V. Evaluation of anastomotic microcirculation after low anterior rectal resection: an experimental study with different reconstruction forms in dogs. Tech Coloproctol. 2006;10:222–6.
Conflict of interest
None of the authors (K. Kubota, M. Yoshida, J. Kuroda, A. Okada, K. Ohta, and M. Kitajima) has any conflict of interest.
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Kubota, K., Yoshida, M., Kuroda, J. et al. Application of the HyperEye Medical System for esophageal cancer surgery: a preliminary report. Surg Today 43, 215–220 (2013). https://doi.org/10.1007/s00595-012-0251-4
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DOI: https://doi.org/10.1007/s00595-012-0251-4