Indocyanine green fluorescence measurement of intestinal transit and gut perfusion after intestinal manipulation.
OBJECTIVE
Postoperative ileus is a common and poorly understood problem of abdominal surgery. The aim of this study was to measure postoperative intestinal transit and to evaluate bowel wall perfusion by a novel in vivo indocyanine green (ICG)-fluorescence measurement following intestinal manipulation (IM).


METHODS
Rats underwent a simple intestinal manipulation. Myeloperoxidase-positive cells in the muscularis were stained with the Hanker-Yates reaction and quantified histochemically. Bowel wall perfusion was determined directly and 24 h postoperatively using a laser-fluorescence detection unit. Intestinal transit was visualized 24 h after IM.


RESULTS
IM resulted in a massive infiltration (155-fold) of neutrophils into the intestinal muscularis 24 h postoperatively. Bowel wall perfusion significantly decreased directly and 24 h following surgery (29 and 59%, respectively). Gastrointestinal transit was similarly impaired and showed a reduction to 40% of the control values 24 h after IM.


CONCLUSIONS
IM of the rat small intestine caused an impairment in bowel wall perfusion and microcirculation and a significant decrease in gastrointestinal transit. The ICG fluorescence measurement using the described system proved to be a simple and reliable method to evaluate intestinal transit and bowel wall microcirculation in vivo.
Behrendt
F F
FF
Department of Surgery, University of Bonn, Bonn, Germany.
Tolba
R H
RH
Overhaus
M
M
Hirner
A
A
Minor
T
T
Kalff
J C
JC
D000818:Animals; D004396:Coloring Agents; D005769:Gastrointestinal Motility; D045823:Ileus / Q000503:physiopathology*; D007208:Indocyanine Green; D007422:Intestines / Q000098:blood supply* / Q000601:surgery*; D007962:Leukocytes / Q000166:cytology; D008297:Male; D008833:Microcirculation; D011183:Postoperative Complications / Q000503:physiopathology; D051381:Rats; D017207:Rats, Sprague-Dawley
D004396:Coloring Agents; D007208:Indocyanine Green