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Perioperative characterization of anastomotic doughnuts with high-resolution probe-based confocal laser endomicroscopy in colorectal cancer surgery: a feasibility study

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Abstract

Background

Confocal laser enables in vivo real-time histopathology of the mucosa layer of gastrointestinal tract. The aim of this study was to assess the feasibility and the role of probe-based confocal laser endomicroscopy in extemporary examination of staple rings of patients with colorectal cancer.

Methods

This was a prospective, single-center pilot study. Patients who underwent end-to-end stapled surgical resection for colorectal cancer were included. Confocal imaging was analyzed with great attention to image quality evaluation of cellular morphology and cellular structures of the serosal, muscular, and mucosal layers of the doughnuts than comparing results with definitive histopathology.

Results

Twenty-six doughnuts were analyzed. Real-time video sequences were obtained in all patients, with a total of 204 mosaic images. For each doughnut, most of the images were adequate for evaluation of cellular morphology and cellular structure of the serosal, muscular, and mucosal layers.

Conclusions

Perioperative assessment of doughnut tissues in patients with colorectal cancer by confocal laser endomicroscopy is feasible and safe. Prospective studies are warranted for further evaluation of the clinical impact of this technology during surgery.

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Disclosures

Drs. Giovanni D. De Palma, Gaetano Luglio, Stefania Staibano, Luigi Bucci, Dario Esposito, Francesco Maione, Massimo Mascolo, Gennaro Ilardi, and Pietro Forestieri have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy

    Giovanni D. De Palma, Gaetano Luglio, Luigi Bucci, Dario Esposito, Francesco Maione & Pietro Forestieri

  2. Center of Excellence for Technical Innovation in Surgery, School of Medicine, University of Naples Federico II, Naples, Italy

    Giovanni D. De Palma

  3. Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy

    Stefania Staibano, Massimo Mascolo & Gennaro Ilardi

Authors
  1. Giovanni D. De Palma
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  2. Gaetano Luglio
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  3. Stefania Staibano
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  4. Luigi Bucci
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  5. Dario Esposito
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  6. Francesco Maione
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  7. Massimo Mascolo
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  8. Gennaro Ilardi
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  9. Pietro Forestieri
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Correspondence to Giovanni D. De Palma.

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De Palma, G.D., Luglio, G., Staibano, S. et al. Perioperative characterization of anastomotic doughnuts with high-resolution probe-based confocal laser endomicroscopy in colorectal cancer surgery: a feasibility study. Surg Endosc 28, 2072–2077 (2014). https://doi.org/10.1007/s00464-014-3429-6

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  • DOI: https://doi.org/10.1007/s00464-014-3429-6

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