title: Transanal near-infrared imaging of colorectal anastomotic perfusion.
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.
authors.affiliation: Division of Minimally Invasive Surgery, Maimonides Medical Center, Brooklyn, NY 11219, USA. dsherwinter@maimonidesmed.org
authors.forename: Danny A
authors.initials: DA
authors.lastname: Sherwinter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000473:pathology / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000473:pathology / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D015203:Reproducibility of Results
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green