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Fluorescence-based bowel anastomosis perfusion evaluation: results from the IHU-IRCAD-EAES EURO-FIGS registry

Authors :
Jan Grosek
Laurents P. S. Stassen
Andrea Balla
Davide Cosola
Catalin Copaescu
Silvia Quaresima
Maurizio Castagnola
Giuseppe Navarra
Paolo De Paolis
Gonzalo P Martin-Martin
Andrea Picchetto
Ivano Dal Dosso
J. Kosir
Marcello Calabrò
Harmony Impellizzeri
Roland Chautems
Carlo Castoro
Mahdi Al-Taher
Gian Luca Baiocchi
Giancarlo D'Ambrosio
G. Moretto
Giovanni Maria Garbarino
Giorgio Bianchi
Giuseppe Spinoglio
Alessandro Franchello
Robert Juvan
Salvador Morales Conde
Carlos Marques Ferreira
Emilio Bertani
Marco Filauro
Nunzio Rosso
Antonio Pesce
Gabriele Anania
Andrea Spota
Lorenzo Casali
Ramon Vilallonga
Marc Olivier Sauvain
Christian Franzini
Orestis Ioannidis
Michele Diana
Eleftherios Gialamas
Alend Saadi
Eric Felli
Gaetano La Greca
Jacques Marescaux
Paola De Nardi
José F. Noguera
Alessio Rollo
Pietro Riva
Nicolò de Manzini
Marta Silvestri
Caterina Santi
Luciano Tartamella
Gregor Norčič
Alessandro Patané
Thomas Carus
Alessandro M. Paganini
Luigi Boni
Surgery
MUMC+: MA Heelkunde (9)
MUMC+: MA AIOS Heelkunde (9)
RS: NUTRIM - R2 - Liver and digestive health
RS: SHE - R1 - Research (OvO)
Spota, A.
Al-Taher, M.
Felli, E.
Morales Conde, S.
Dal Dosso, I.
Moretto, G.
Spinoglio, G.
Baiocchi, G.
Vilallonga, R.
Impellizzeri, H.
Martin-Martin, G. P.
Casali, L.
Franzini, C.
Silvestri, M.
de Manzini, N.
Castagnola, M.
Filauro, M.
Cosola, D.
Copaescu, C.
Garbarino, G. M.
Pesce, A.
Calabro, M.
de Nardi, P.
Anania, G.
Carus, T.
Boni, L.
Patane, A.
Santi, C.
Saadi, A.
Rollo, A.
Chautems, R.
Noguera, J.
Grosek, J.
D'Ambrosio, G.
Ferreira, C. M.
Norcic, G.
Navarra, G.
Riva, P.
Quaresima, S.
Paganini, A.
Rosso, N.
De Paolis, P.
Balla, A.
Sauvain, M. O.
Gialamas, E.
Bianchi, G.
La Greca, G.
Castoro, C.
Picchetto, A.
Franchello, A.
Tartamella, L.
Juvan, R.
Ioannidis, O.
Kosir, J. A.
Bertani, E.
Stassen, L.
Marescaux, J.
Diana, M.
Source :
Surgical endoscopy and other interventional techniques, 35(12), 7142-7153. Springer, Cham
Publication Year :
2021

Abstract

Background: Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Near-infrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry. Methods: Analysis of data prospectively collected by the registry members provided patient and procedural data along with the ICG dose, timing, and consequences of NIRF imaging. Among the included upper-GI, colorectal, and bariatric surgeries, subgroup analysis was performed to identify risk factors associated with complications. Results: A total of 1240 patients were included in the study. The included patients, 74.8% of whom were operated on for cancer, originated from 8 European countries and 30 hospitals. A total of 54 surgeons performed the procedures. In 83.8% of cases, a pre-anastomotic ICG dose was administered, and in 60.1% of cases, a post-anastomotic ICG dose was administered. A significant difference (p < 0.001) was found in the ICG dose given in the four pathology groups registered (range: 0.013–0.89mg/kg) and a significant (p < 0.001) negative correlation was found between the ICG dose and BMI. In 27.3% of the procedures, the choice of the anastomotic level was guided by means of NIRF imaging which means that in these cases NIRF imaging changed the level of anastomosis which was first decided based on visual findings in conventional white light imaging. In 98.7% of the procedures, the use of ICG partly or strongly provided a sense of confidence about the anastomosis. A total of 133 complications occurred, without any statistical significance in the incidence of complications in the anastomoses, whether they were ICG-guided or not. Conclusion: The EURO-FIGS registry provides an insight into the current clinical practice across Europe with respect to NIRF imaging of anastomotic perfusion during digestive tract surgery.

Subjects

Subjects :
medicine.medical_specialty
Registry
RESECTION
INDOCYANINE GREEN
Subgroup analysis
Anastomotic Leak
Near-infrared fluorescence imaging
Anastomosis
Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Nearinfrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion
NO
03 medical and health sciences
COLORECTAL-SURGERY
ESOPHAGECTOMY
0302 clinical medicine
LEAKAGE
Statistical significance
Internal medicine
medicine
Humans
Image-guided surgery
Registries
Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Nearinfrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry
COMPLICATIONS
CONSEQUENCES
business.industry
Incidence (epidemiology)
Anastomosis, Surgical
Hepatology
CANCER
facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry
Perfusion
Surgery, Computer-Assisted
030220 oncology & carcinogenesis
RISK-FACTORS
fluorescence-guided surgery
image-guided surgery
near-infrared fluorescence imaging
registry
Fluorescence-guided surgery
030211 gastroenterology & hepatology
Surgery
Radiology
ENHANCED REALITY
business
Abdominal surgery

Details

Language :
English
ISSN :
09302794
Database :
OpenAIRE
Journal :
Surgical endoscopy and other interventional techniques, 35(12), 7142-7153. Springer, Cham
Accession number :
edsair.doi.dedup.....8f61aaf384ec82f94c83e149e6735ba8