| Title: |
The Role of Quantitative Indocyanine Green Angiography with Relative Perfusion Ratio in the Assessment of Gastric Conduit Perfusion in Oesophagectomy: A Retrospective Study |
| Authors: |
Lee Shyang Kyang; Nurojan Vivekanandamoorthy; Simeng Li; David Goltsman; Aldenb Lorenzo; Neil Merrett |
| Source: |
Journal of Clinical Medicine ; Volume 15 ; Issue 1 ; Pages: 184 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2025 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
indocyanine green; icg; anastomotic leak; oesophageal cancer; oesophagectomy |
| Description: |
Background: Anastomotic leak (AL) after esophagectomy remains a devastating complication. Indocyanine green (ICG) fluorescence angiography may mitigate this risk by enabling perfusion-guided anastomotic site selection. This study evaluates the feasibility of quantitative ICG angiography using the SPY-PHI QP® system (Stryker AB, Malmö, Sweden) during gastric conduit reconstruction. Methods: Six patients undergoing esophagectomy (Ivor Lewis/McKeown) after neoadjuvant therapy were retrospectively identified. ICG angiography was performed intraoperatively, with perfusion at the gastric conduit quantified as a relative perfusion ratio (RPR) using the first duodenal segment as the reference (100%). Anastomotic sites were selected based on maximal RPR (threshold > 80%). Postoperative outcomes included AL incidence (radiological/clinical), complications (Clavien–Dindo), and 90-day mortality. Results: All patients (median age: 69 years) underwent successful perfusion assessment. Adenocarcinoma predominated (50%, 3/6), with most tumours at the gastroesophageal junction (Siewert II: 66%). Intraoperative RPR at anastomotic sites ranged from 80% to 100%. No anastomotic leaks occurred. Complications included Clavien–Dindo grade II (n = 3; respiratory infections) and grade IV (n = 2; reintubation). There was no 90-day mortality. Conclusions: Quantitative ICG angiography using the SPY-PHI QP® system facilitated perfusion-guided anastomosis with no leaks observed. Standardising perfusion assessment based on an RPR threshold of >80% may enhance surgical safety, though larger studies are needed to validate these findings. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Gastroenterology & Hepatopancreatobiliary Medicine; https://dx.doi.org/10.3390/jcm15010184 |
| DOI: |
10.3390/jcm15010184 |
| Availability: |
https://doi.org/10.3390/jcm15010184 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.5A11A850 |
| Database: |
BASE |