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Esophagectomy, followed by esophageal replacement using gastric/colonic conduits, is a complex surgical procedure with significant perioperative morbidity. The most significant and potentially life-threatening complication associated with esophageal replacement is conduit ischaemia, resulting in anastomotic leak and conduit necrosis. Ensuring adequate perfusion of the conduit remains the key to preventing conduit ischaemia. Indocyanine green (ICG) enhanced near-infrared fluorescence imaging is a novel technique which has been used for assessing bowel perfusion. While numerous studies have focused on ICG fluorescence imaging for assessment of gastric conduit perfusion after esophagectomy, data regarding its use for colonic conduits is limited to case reports. ICG fluorescence imaging can help in resolving intraoperative issues by predicting the adequacy of colonic conduit perfusion, thereby preventing postoperative morbidity. To the best of our knowledge, this is the first report in Indian literature describing the utility of ICG fluorescence imaging for assessment of perfusion of colonic interposition. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To assess the accuracy of CT scan in preoperative staging, to correlate preoperative findings with operative findings and with post-operative histopathological findings of colorectal carcinoma. Methods: Twenty-six diagnosed cases of colorectal carcinoma were included in the study. They were evaluated preoperatively by 64 slice multidetector CT (MDCT) scan. Intra-operative evaluation was done at the time of surgery. Post-operative evaluation was based on detailed histological examination by experienced pathologist. Data was statistically assessed by SPSS software (version 14.0) and the correlation was deduced from “kappa” value and “P”. Results: The correlation of CT scan staging is significant (P ≤ 0.0001) when compared to intra-operative staging. MDCT findings correlated with intra-operative findings in terms of site of lesion (P < 0.001), serosa involvement (P < 0.0001), involvement of circumference (P < 0.0001), pericolic/perirectal fat involvement (P < 0.009) and assessment of lymph nodes (P = 0.004). In estimating size of lesion, it also correlated with the intra-operative findings (44 %). MDCT findings correlated with histopathological findings in terms of site of lesion (P < 0.001), circumference involved (P < 0.0001), serosal involvement (P = 0.018) and size of lesion. The CT findings did not correlated significantly in terms of pericolic/ perirectal fat involvement (P = 0.127) and assessment of lymph nodes (P = 0.68). Conclusion: Multidetector CT scan can be useful in the preoperative assessment of patients with colorectal carcinoma as a means for assisting surgical planning. [Copyright &y& Elsevier]