title: Usefulness of indocyanine green angiography for evaluation of blood supply in a reconstructed gastric tube during esophagectomy.
abstract: We report a case of necrosis of a reconstructed gastric tube in a 77-year-old male patient who had undergone esophagectomy. At the time of admission, the patient had active gastric ulcers, but these were resolved by treatment with a proton pump inhibitor. Subtotal esophagectomy with gastric tube reconstruction was performed. Visually, the reconstructed gastric tube appeared to be well perfused with blood. Using indocyanine green (ICG) fluorescence imaging the gastroepiploic vessels were well enhanced and no enhancement was visable 3 to 4 cm from the tip of the gastric tube. Four days after esophagectomy, gastric tube necrosis was confirmed, necessitating a second operation. The necrosis of the gastric tube matched the area that had been shown to lack blood perfusion by ICG angiography imaging. It seems that ICG angiography is useful for the evaluation of perfusion in a reconstructed gastric tube.
authors.affiliation: 1  Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kumagai
authors.forename: Tomojiro
authors.initials: T
authors.lastname: Ono
authors.forename: Hideko
authors.initials: H
authors.lastname: Imaizumi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Honjo
authors.forename: Okihide
authors.initials: O
authors.lastname: Suzuki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ito
authors.forename: Norihiro
authors.initials: N
authors.lastname: Haga
authors.forename: Kohki
authors.initials: K
authors.lastname: Kuwabara
authors.forename: Jun
authors.initials: J
authors.lastname: Sobajima
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kumamoto
authors.forename: Keiichoro
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Baba
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ishida
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Kawano
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D016629:Esophagectomy; D004947:Esophagus / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D005451:Fluorescein Angiography / Q000379:methods*; D005456:Fluorescent Dyes; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D013270:Stomach / Q000098:blood supply* / Q000473:pathology / Q000601:surgery
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green