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Indocyanine green fluorescence imaging improves the assessment of blood supply of interposition jejunum

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Abstract

Objectives

The blood supply of the transposed jejunum was assessed by ICG fluorescence imaging in jejunal interposition, and the correlation with anastomotic leakage or transposed jejunal necrosis was analyzed, aim to explore the value of the application ICG fluorescence imaging technology.

Methods

84 esophageal reconstructions with jejunal interposition without supercharging were retrospectively analyzed. Intraoperatively, the blood supply of transposed jejunal was observed using ICG fluorescence endoscopy. ROC curve of T1/2 was constructed to calculate the corresponding T1/2max value of the region where the transposed jejunal want to be anastomosed with esophageal stump, the relationship between T1/2max value and anastomotic leakage or transposed jejunal necrosis was analyzed.

Results

The occurrence of anastomotic leakage and transposed jejunal necrosis was 9.5%, In the ROC curve, the maximum value of the Youden index was 0.691, the T1/2max value was 5.35 s. When T1/2max value > 5.35 s correspondingly, the probability of anastomotic leakage or transposition jejunal necrosis was 33.3% (7/21); when T1/2max value ≤ 5.35 s, the probability of anastomotic leakage or transposition jejunal necrosis was 1.6% (1/63). The difference between the two groups was statistically significant (P < 0.05).

Conclusion

ICG fluorescent imaging can effectively assess the blood supply of transposed jejunum. When T1/2max > 5.35, the possibility of the incidence rate of anastomotic leakage or transposed jejunum necrosis increases, this will remind the operators to take corresponding remedial measures during operation.

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Abbreviations

ICG:

Indocyanine green fluorescence imaging

ROC:

Receiver operating characteristic

AUC:

Area under the ROC curve

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Acknowledgements

The authors would like to thank Editage (www.editage.cn) for English language editing.

Funding

This work was supported by a grant from Fujian university of Traditional Chinese Medicine management project clinical special funding (XB2019118).

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Author notes

  1. Zhaoxian Lin and Shihui Sun contributed equally to this work.

Authors and Affiliations

  1. Department of Thoracic Surgery, Fujian Provincial Hospital, Shengli School of Clinical Medicine of Fujian Medical University, Dong street No. 134, Fuzhou, 350001, Fujian province, China

    Zhaoxian Lin, Shihui Sun, Yangming Chen, Jianyuan Huang, Yangyun Huang, Jiguang Zhang, Debin Ou & Xing Lin

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  1. Zhaoxian Lin
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  2. Shihui Sun
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  3. Yangming Chen
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Correspondence to Xing Lin.

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Disclosures

Drs. Xing Lin, Zhaoxian Lin, Shihui Sun, Yangming Chen, Jianyuan Huang, Yangyun Huang, Jiguang Zhang, Debin Ou have no conflicts of interest or financial ties to disclose.

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki and after receiving the approval of the Institutional Review Board (No. K2016-023-03) of Fujian Provincial Hospital. Written informed consent was obtained from all patients included in this study. The present record does not include personal data, photographs, or other material that might identify the participants of our research. Personal data were not given out and will not be given out without the consent of our patients.

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Lin, Z., Sun, S., Chen, Y. et al. Indocyanine green fluorescence imaging improves the assessment of blood supply of interposition jejunum. Surg Endosc 36, 6456–6463 (2022). https://doi.org/10.1007/s00464-021-08996-9

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  • DOI: https://doi.org/10.1007/s00464-021-08996-9

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