Perfusion Assessment in Laparoscopic Left-Sided/Anterior Resection (PILLAR II): A Multi-Institutional Study

Jafari, Mehraneh D.; Wexner, Steven D.; Martz, Joseph; McLemore, Elisabeth C.; Margolin, David A.; Sherwinter, Danny A.; Lee, Sang W.; Senagore, Anthony J.; Phelan, Michael; Stamos, Michael J.

doi:10.1016/j.jamcollsurg.2014.09.015

Cited by 476 publications

(376 citation statements)

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“…Unlike previous studies, the present experience includes patients, procedures, surgical access and anastomotic levels not extensively studied previously using NIR‐ICG technology. The leak rates and frequency of change in intraoperative plan are consistent with those in the PILLAR II trial13.…”

Section: Discussionsupporting

confidence: 75%

Multicentre phase II trial of near-infrared imaging in elective colorectal surgery

Ris

Liot

Buchs

et al. 2018

British Journal of Surgery

169

138

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BackgroundDecreasing anastomotic leak rates remain a major goal in colorectal surgery. Assessing intraoperative perfusion by indocyanine green (ICG) with near‐infrared (NIR) visualization may assist in selection of intestinal transection level and subsequent anastomotic vascular sufficiency. This study examined the use of NIR‐ICG imaging in colorectal surgery.MethodsThis was a prospective phase II study (NCT02459405) of non‐selected patients undergoing any elective colorectal operation with anastomosis over a 3‐year interval in three tertiary hospitals. A standard protocol was followed to assess NIR‐ICG perfusion before and after anastomosis construction in comparison with standard operator visual assessment alone.ResultsFive hundred and four patients (median age 64 years, 279 men) having surgery for neoplastic (330) and benign (174) pathology were studied. Some 425 operations (85·3 per cent) were started laparoscopically, with a conversion rate of 5·9 per cent. In all, 220 patients (43·7 per cent) underwent high anterior resection or reversal of Hartmann's operation, and 90 (17·9 per cent) low anterior resection. ICG angiography was achieved in every patient, with a median interval of 29 s to visualization of the signal after injection. NIR‐ICG assessment resulted in a change in the site of bowel division in 29 patients (5·8 per cent) with no subsequent leaks in these patients. Leak rates were 2·4 per cent overall (12 of 504), 2·6 per cent for colorectal anastomoses and 3 per cent for low anterior resection. When NIR‐ICG imaging was used, the anastomotic leak rates were lower than those in the participating centres from over 1000 similar operations performed with identical technique but without NIR‐ICG technology.ConclusionRoutine NIR‐ICG assessment in patients undergoing elective colorectal surgery is feasible. NIR‐ICG use may change intraoperative decisions, which may lead to a reduction in anastomotic leak rates.

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Section: Discussionsupporting

confidence: 75%

Multicentre phase II trial of near-infrared imaging in elective colorectal surgery

Ris

Liot

Buchs

et al. 2018

British Journal of Surgery

169

138

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“…В настоящий момент мы можем обобщить опуб-ликованные результаты 8 серий клинических наблю-дений (от 3 до 119 пациентов) [23, [26][27][28][29][30][31][32], 3 контроли-руемых исследований [33-35] и 1 проспективного мультицентрового исследования [36]. Частота возник-новения несостоятельности первичного анастомоза варьирует в различных исследованиях и может дости-гать 20 % [5][6][7].…”

Section: результатыunclassified

“…Частота возник-новения несостоятельности первичного анастомоза варьирует в различных исследованиях и может дости-гать 20 % [5][6][7]. По современным данным, регист-рируется снижение частоты несостоятельностей до 1-4 % на фоне выполненной интраоперационной флуоресцентной визуализации адекватности крово-снабжения анастомозируемых участков кишки [34,36].…”

Section: результатыunclassified

“…При ретроспективном анализе эффективности данной методики в роботической хирургии рака прямой киш-ки показано снижение частоты несостоятельностей анастомоза с 18 до 6 % [33]. На сегодняшний день наиболее репрезентативные данные по клиническому применению флуоресцентной ангиографии в пла-новой колопроктологии получены в исследовании PILLAR II (Perfusion Assessment in Laparoscopic LeftSided / Anterior Resection) [36]. Данное исследование является проспективным, открытым и мультицентро-вым.…”

Section: результатыunclassified

“…6 Colorectal КОЛОПРОКТОЛОГИЯ 3' 2016 О р и г и н а л ь н ы е и с с л е д о в а н и я анастомоза отмечена на уровне 1,4 %. При этом несо-стоятельности анастомоза не отмечено ни в одном из 11 наблюдений, когда был изменен уровень пересе-чения кишки [36].…”

Section: результатыunclassified

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Intraoperative fluorescence angiography in objectification of relegated colon perfusion in oncocoloproctology: first Russian experience and review of the literature

Кочатков¹,

Lyadov²,

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et al. 2016

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In Vivo Fluorescence Imaging

Lin¹,

Liu²,

Quiroz³

2022

Encyclopedia of Analytical Chemistry

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In vivo fluorescence imaging is an essential tool for many biomedical researches and clinical applications. It provides intuitive, direct evidence to help researchers understand complicated biological phenomena and clinicians to make better decisions. In this article, we will introduce important tissue optical properties that determine the performance of in vivo fluorescence images. Besides the biological specimen itself, imaging methods and fluorophores are the two key components that determine its performance and capabilities. Several types of imaging methods, suitable cameras, and the currently available fluorophores will be described. In the last section, we focus on the clinical applications, mainly image‐guided surgeries. The future development of in vivo fluorescence imaging tackles the challenge of deep tissue imaging, and short‐wave infrared fluorescence will be our new solution. Therefore, we will also comment on the recent developments of SWIR techniques in each topic discussed.

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Perfusion Assessment in Laparoscopic Left-Sided/Anterior Resection (PILLAR II): A Multi-Institutional Study

Abstract: PINPOINT is a safe and feasible tool for intraoperative assessment of tissue perfusion during colorectal resection. There were no anastomotic leaks in patients in whom the anastomosis was revised based on inadequate perfusion with FA.

Cited by 476 publications

References 37 publications

Multicentre phase II trial of near-infrared imaging in elective colorectal surgery

Multicentre phase II trial of near-infrared imaging in elective colorectal surgery

Intraoperative fluorescence angiography in objectification of relegated colon perfusion in oncocoloproctology: first Russian experience and review of the literature

In Vivo Fluorescence Imaging

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