title: The novel use of intraoperative laser-induced fluorescence of indocyanine green tissue angiography for evaluation of the gastric conduit in esophageal reconstructive surgery.
abstract: BACKGROUND
  Esophagectomy with reconstruction using a gastric conduit is associated with a relatively high rate of anastomotic leakage. We used indocyanine green tissue angiography to evaluate the gastric conduit intraoperatively before gastroesophageal anastomosis to identify ischemia.
  
  
  METHODS
  We performed an institutional review board-approved retrospective review of all esophagectomies performed from 2010 to the beginning of 2011. Patient histories and perioperative outcomes were reviewed retrospectively. Postoperative morbidity and 30-day mortality were determined.
  
  
  RESULTS
  Eleven patients had an esophagectomy performed using this technology. All had adequate perfusion on gross examination. All but 1 had good perfusion with tissue angiography, and there were 2 anastomotic leakages leaks including this patient. There were no mortalities at 30 days.
  
  
  CONCLUSIONS
  We report preliminary results using this imaging system in esophageal reconstructive surgery. Larger randomized controlled studies are needed to determine if surgical outcomes can be improved using this technology.
authors: Springfield Clinic, 801 North 1st Street, Springfield, IL 62702, USA. ppacheco@springfieldclinic.com
authors: Paul Evan
authors: PE
authors: Pacheco
authors: Sean M
authors: SM
authors: Hill
authors: Steven M
authors: SM
authors: Henriques
authors: J Kevin
authors: JK
authors: Paulsen
authors: Richard C
authors: RC
authors: Anderson
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000000981:diagnostic imaging; D000792:Angiography / Q000379:methods*; D001706:Biopsy; D059248:Chemoradiotherapy; D004396:Coloring Agents; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D016629:Esophagectomy / Q000379:methods*; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D007432:Intraoperative Period; D007834:Lasers; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green