Transanal near-infrared imaging of colorectal anastomotic perfusion

Surg Laparosc Endosc Percutan Tech. 2012 Oct;22(5):433-6. doi: 10.1097/SLE.0b013e3182601eb8.

Abstract

The influence of perfusion on colorectal anastomotic healing and, conversely, the role of ischemia in anastomotic dehiscence have been reported by many investigators, and yet identifying a modality that can evaluate perfusion in real time and thus guide intraoperative management has proven elusive. This study describes our initial experience using transanal near-infrared (NIR) imaging to evaluate anastomotic perfusion after colorectal anastomoses. Patients undergoing colectomy with an anastomosis within 25 cm of the anal verge were included in this study. A transanal NIR system was used to assess mucosal perfusion at the level of the anastomoses. The rectum was easily navigated under direct vision and the anastomotic staple line visualized. High-quality NIR mucosal angiography was obtained in all subjects, confirming that transanal NIR angiography is feasible and simple to perform. Although NIR mucosal angiography is a promising modality, further study is needed to correlate this technique to the clinical outcome.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anal Canal / pathology
  • Anal Canal / surgery*
  • Anastomosis, Surgical / methods
  • Colectomy / methods*
  • Colon / pathology
  • Colon / surgery*
  • Colonoscopy / methods*
  • Coloring Agents
  • Female
  • Humans
  • Indocyanine Green*
  • Male
  • Middle Aged
  • Rectum / pathology
  • Rectum / surgery*
  • Reproducibility of Results

Substances

  • Coloring Agents
  • Indocyanine Green