The Utility of Indocyanine Green Angiography in the Assessment of Perfusion of Gastric Conduit and Proximal Esophageal Stump Against Visual Assessment in Patients Undergoing Esophagectomy: a Prospective Study

Thammineedi, Subramanyeshwar Rao; Patnaik, Sujit Chyau; Saksena, Ajesh Raj; Ramalingam, Pratap Reddy; Nusrath, Syed

doi:10.1007/s13193-020-01085-8

Cited by 16 publications

(10 citation statements)

References 18 publications

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“…Koyanagi et al 32 classified fluorescence into two groups: simultaneous (simultaneous flow speed of ICG fluorescence in the gastric conduit and greater curvature vessels) and delayed (slower ICG fluorescence flow speed in gastric conduit than greater curvature vessels) according to the ICG flow speed (cm/s). The importance of proximal esophageal stump perfusion assessment has also been emphasized by Thammineedi et al 22 In their study, 5 of 13 patients (38.46%) required revision of the proximal esophageal stump after an NIR‐ICG assessment. Further large‐scale studies and randomized controlled trials (RCTs) are required to confirm the benefit of ICG evaluation of gastric conduit during esophagectomy (Figure 2).…”

Section: Clinical Applications and Relevancementioning

confidence: 83%

“…Visual inspection alone could be inaccurate in estimating the vascularity of the gastric conduit. 22 Literature reported AL rates to vary from 10% to 20% following esophagectomy. Two meta-analyses have reported a 70% AL risk reduction following the use of ICG, 23,24 with a 25% change in the management intraoperatively.…”

Section: Gastric Conduit Perfusionmentioning

confidence: 99%

“…The vascularity at the tip of the conduit can be precarious as the entire gastric conduit is solely based on the right gastroepiploic artery. Visual inspection alone could be inaccurate in estimating the vascularity of the gastric conduit 22 . Literature reported AL rates to vary from 10% to 20% following esophagectomy.…”

Section: Clinical Applications and Relevancementioning

confidence: 99%

See 2 more Smart Citations

Fluorescence‐guided cancer surgery—A new paradigm

Thammineedi

Saksena

Nusrath

et al. 2021

Journal of Surgical Oncology

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Fluorescence-guided surgery is an emerging and promising operative adjunct to assist the surgeon in various aspects of oncosurgery, ranging from assessing perfusion, identification, and characterization of tumors and peritoneal metastases, mapping of lymph nodes/leaks, and assistance for fluorescence-guided surgery (FGS). This study aims to provide an overview of principles, currently available dyes, platforms, and surgical applications and summarizes the available literature on the utility of FGS with a focus on abdomino-thoracic malignancies.

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Section: Clinical Applications and Relevancementioning

confidence: 83%

Section: Gastric Conduit Perfusionmentioning

confidence: 99%

Section: Clinical Applications and Relevancementioning

confidence: 99%

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Fluorescence‐guided cancer surgery—A new paradigm

Thammineedi

Saksena

Nusrath

et al. 2021

Journal of Surgical Oncology

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“…It is generally accepted that ensuring and improving adequate blood supply affects leak rates in esophageal anastomoses [17]. Visual assessment of gastric conduit perfusion is considered inadequate [18]. Fluorescence perfusion assessment offers opportunity to study real time blood supply to the anastomotic segments.…”

Section: Challenges In Esophagectomymentioning

confidence: 99%

Scope of Real Time Fluorescence Imaging in Esophagectomy

Thammineedi¹,

Shukla²,

Nusrath³

et al. 2023

Esophageal Surgery - Current Principles and Advances

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Esophagectomy is a challenging surgery that is known to be associated with high rates of morbidity. Anastomotic leaks, pneumonia, conduit necrosis and chyle leaks are the commonly reported complications. Perfusion assessment and tissue injection based fluorescence guided surgery (FGS) are the newer clinical applications of fluorescent dyes. With the advent and integration of real time fluorescence imaging with the existing minimal access platforms, the esophageal surgeon can employ these techniques to potentially improve outcomes. During thoracic dissection, thoracic duct lymphography, fluorescence guided airway visualization, tracheal perfusion assessment and sentinel lymph node biopsy/dissection are the reported clinical applications. In the abdominal dissection, gastroepiploic arcade identification, gastric conduit perfusion assessment and proximal esophagus perfusion assessment have been described. Using the different routes of administration, the same dye can be used for different uses at separate points in a single esophagectomy surgery. The principles and evidence pertaining to these applications have been outlined.

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“…NIR angiography using ICG has recently been adopted in many centers. Data from available studies are listed in Table 1 (38,39,(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)40,58,(41)(42)(43)(44)(45)(46)(47).…”

Section: Angiography Of Blood Supply Of Different Organsmentioning

confidence: 99%

Near-Infrared Fluorescence Image-Guided Surgery in Esophageal and Gastric Cancer Operations

et al. 2022

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Background Near-infrared fluorescence image-guided surgery helps surgeons to see beyond the classical eye vision. Over the last few years, we have witnessed a revolution which has begun in the field of image-guided surgery. Purpose, and Research design Fluorescence technology using indocyanine green (ICG) has shown promising results in many organs, and in this review article, we wanted to discuss the 6 main domains where fluorescence image-guided surgery is currently used for esophageal and gastric cancer surgery. Study sample and data collection Visualization of lymphatic vessels, tumor localization, fluorescence angiography for anastomotic evaluation, thoracic duct visualization, tracheal blood flow analysis, and sentinel node biopsy are discussed. Conclusions It seems that this technology has already found its place in surgery. However, new possibilities and research avenues in this area will probably make it even more important in the near future.

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The Utility of Indocyanine Green Angiography in the Assessment of Perfusion of Gastric Conduit and Proximal Esophageal Stump Against Visual Assessment in Patients Undergoing Esophagectomy: a Prospective Study

Cited by 16 publications

References 18 publications

Fluorescence‐guided cancer surgery—A new paradigm

Fluorescence‐guided cancer surgery—A new paradigm

Scope of Real Time Fluorescence Imaging in Esophagectomy

Near-Infrared Fluorescence Image-Guided Surgery in Esophageal and Gastric Cancer Operations

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