Gastroscopy assisted laser Doppler flowmetry and visible light spectroscopy in patients with chronic mesenteric ischemia

Berge, Simen Tveten; Safi, Nathkai; Medhus, Asle W.; Ånonsen, Kim Vidar; Sundhagen, Jon Otto; Hisdal, Jonny; Kazmi, Syed Sajid Hussain

doi:10.1080/00365513.2019.1672084

Cited by 15 publications

(13 citation statements)

References 96 publications

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“…Only two studies incorporated both LDF and VLS. 15,23 The former was the investigation of transmucosal microcirculation in patients with non-specific abdominal pain, and the latter included patients with chronic mesenteric ischemia and a control group with non-specific abdominal pain. Other studies such as Pham et al had no real-time measurements, while Wang et al excluded patients with anastomotic leaks.…”

Section: Discussionmentioning

confidence: 99%

“…The graphical picture provided by the LCD monitor of the O2C unit, help to keep the absorption spectra of oxyhemoglobin well above 50% of the arbitrary unit (AU) scale during examinations ( Figure 1A and B). 15 This step allowed us to perform the repeated transserosal measurements in all subjects without applying unnecessary pressure on the serosa. Before each recording, an ambient light correction was performed automatically, which allowed keeping the examined area illuminated and maintaining the O2C microprobe's visual control throughout the examination.…”

Section: Methodsmentioning

confidence: 99%

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Laser Doppler Flowmetry and Visible Light Spectroscopy of the Gastric Tube During Minimally Invasive Esophagectomy

Safi¹,

Johannessen²,

Medhus³

et al. 2020

VHRM

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Introduction: Ischemia is considered as the main reason for thoracic gastroesophageal anastomotic leaks after esophagectomy. Microcirculatory monitoring with laser Doppler flowmetry and visible light spectroscopy may provide valuable intraoperative real-time information about the gastric tube's tissue perfusion and circulation. Patients and Methods: Ten patients with esophageal cancer operated with minimally invasive esophagectomy participated in this single-center, prospective, observational pilot study. A single probe with laser Doppler flowmetry and visible light spectroscopy was used to perform transserosal microcirculation assessment of the gastric tube at predefined anatomical sites during different operation phases. Group comparison and changes were evaluated using the paired sample t-test. Results: A reduction in StO2 was found at all measuring sites after the gastric tube formation compared with the baseline measurements. The mean StO2 reduction from baseline to gastric tube formation and after anastomosis was 16% (range 4%-28%) and 42% (range, 35%-52%), respectively. A statistically significant increase in the rHb concentration, representing venous congestion, was detected at the most cranial part of the gastric tube (P = 0.04). Three patients developed anastomotic leaks. Conclusion: Intraoperative real-time laser Doppler flowmetry and visible light spectroscopy are feasible and may provide insight to microcirculatory changes in the gastric tube and at the anastomotic site. Patients with anastomotic leaks seem to have critical local tissue StO2 reduction and venous congestion that should be further evaluated in studies with larger sample sizes.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Laser Doppler Flowmetry and Visible Light Spectroscopy of the Gastric Tube During Minimally Invasive Esophagectomy

Safi¹,

Johannessen²,

Medhus³

et al. 2020

VHRM

Self Cite

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“…All included patients were participating in an ongoing clinical study on chronic mesenteric ischemia. 11 The study was approved by the Regional Committees for Medical and Health Research Ethics in the South-Eastern region of Norway (REK sør-øst B 2016/682) and registered in the ClinicalTrials.gov Protocol Registration and Results System (NCT02914912). The patients gave informed written consent for inclusion in the study and the operative procedure.…”

Section: Ethics and Trial Registrationmentioning

confidence: 99%

A Short Series of Laparoscopic Mesenteric Bypasses for Chronic Mesenteric Ischemia

Kazmi¹,

Berge²,

Sahba³

et al. 2020

VHRM

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Background: Laparoscopic aortomesenteric bypass may be performed to treat the chronic mesenteric ischemia patients who are not suitable for endovascular treatment. This study presents an initial experience with a limited series of laparoscopic mesenteric artery revascularization for the treatment of mesenteric ischemia. Methods: Chronic mesenteric ischemia (CMI) patients with previous unsuccessful endovascular treatment or with arterial occlusion and extensive calcification precluding safe endovascular treatment were offered laparoscopic mesenteric revascularization. From October 2015 until November 2018, nine patients with CMI underwent laparoscopic revascularization. In addition to demographic data and perioperative results of the treatment, graft patency was assessed with Duplex ultrasound at 1, 3, 6 and 12 months, and annually thereafter. A descriptive analysis of the data was performed. Results: All bypasses were constructed with an 8 mm ring enforced expanded polytetrafluoroethylene graft in a retrograde fashion (from infrarenal aorta or iliac artery) to either superior mesenteric artery or splenic artery (2 cases). Median operation time was 356 mins (range 247-492 mins). Five patients had a history of unsuccessful endovascular treatment. Laparoscopic technical success was 78%, and the primary open conversion rate was 22%. All laparoscopic revascularization procedures remained patent after discharge during a median follow-up time of 26 months (range 18-49 months). The primary graft patency at 30 days was 78%. Primary assisted, and secondary graft patency was 78% and 100%, respectively. Median weight gain was 2 kg (range 2-18 kg), and all patients achieved relief from postprandial pain and nausea. No mortality was observed during the follow-up period. Conclusion: Laparoscopic aortomesenteric revascularization procedures for chronic mesenteric ischemia are feasible but require careful patient selection. These procedures should only be performed at referral centers by vascular surgeons with prior experience in laparoscopic vascular surgery.

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“…This method has a sufficient time resolution and depth of probing (about 1 mm [17]) to register the blood microflow fluctuations of different origin, as well as the average level of blood perfusion. The range of applications of the non-invasive diagnostics by the LDF method covers the topics of relationship between oxygen saturation and blood flow [18], dental pulp blood flow [19], blood flow analysis in cases of type 1 diabetes mellitus [20] and rheumatic diseases [21], combining LDF and endoscopy during surgery interventions [22,23], nonlinear blood flow dynamics analysis in a various application [24,25], analysis of transdermal transport of drugs [26] and registration of arterial hypertension associated changes in microcirculation [27]. Numerically, the resulting value for the blood perfusion in the LDF technique is commonly given by the expression:…”

Section: Introductionmentioning

confidence: 99%

Laser Doppler Spectrum Analysis Based on Calculation of Cumulative Sums Detects Changes in Skin Capillary Blood Flow in Type 2 Diabetes Mellitus

et al. 2021

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In this article, we introduce a new method of signal processing and data analysis for the digital laser Doppler flowmetry. Our approach is based on the calculation of cumulative sums over the registered Doppler power spectra. The introduced new parameter represents an integral estimation for the redistribution of moving red blood cells over the range of speed. The prototype of the device implementing the technique is developed and tested in preliminary clinical trials. The methodology was verified with the involvement of two age groups of healthy volunteers and in a group of patients with type 2 diabetes mellitus. The main practical result of the study is the development of a set of binary linear classifiers that allow the method to identify typical patterns of the microcirculation for the healthy volunteers and diabetic patients based on the presented diagnostic algorithm.

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Gastroscopy assisted laser Doppler flowmetry and visible light spectroscopy in patients with chronic mesenteric ischemia

Abstract: Hedvig and Ingrid. Thank you for all the love and happiness you surround me with every day.

Cited by 15 publications

References 96 publications

<p>Laser Doppler Flowmetry and Visible Light Spectroscopy of the Gastric Tube During Minimally Invasive Esophagectomy</p>

<p>Laser Doppler Flowmetry and Visible Light Spectroscopy of the Gastric Tube During Minimally Invasive Esophagectomy</p>

<p>A Short Series of Laparoscopic Mesenteric Bypasses for Chronic Mesenteric Ischemia</p>

Laser Doppler Spectrum Analysis Based on Calculation of Cumulative Sums Detects Changes in Skin Capillary Blood Flow in Type 2 Diabetes Mellitus

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