title: Perioperative characterization of anastomotic doughnuts with high-resolution probe-based confocal laser endomicroscopy in colorectal cancer surgery: a feasibility study.
abstract: BACKGROUND
  Confocal laser enables in vivo real-time histopathology of the mucosa layer of gastrointestinal tract. The aim of this study was to assess the feasibility and the role of probe-based confocal laser endomicroscopy in extemporary examination of staple rings of patients with colorectal cancer.
  
  
  METHODS
  This was a prospective, single-center pilot study. Patients who underwent end-to-end stapled surgical resection for colorectal cancer were included. Confocal imaging was analyzed with great attention to image quality evaluation of cellular morphology and cellular structures of the serosal, muscular, and mucosal layers of the doughnuts than comparing results with definitive histopathology.
  
  
  RESULTS
  Twenty-six doughnuts were analyzed. Real-time video sequences were obtained in all patients, with a total of 204 mosaic images. For each doughnut, most of the images were adequate for evaluation of cellular morphology and cellular structure of the serosal, muscular, and mucosal layers.
  
  
  CONCLUSIONS
  Perioperative assessment of doughnut tissues in patients with colorectal cancer by confocal laser endomicroscopy is feasible and safe. Prospective studies are warranted for further evaluation of the clinical impact of this technology during surgery.
authors: Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy, giovanni.depalma@unina.it.
authors: Giovanni D
authors: GD
authors: De Palma
authors: Gaetano
authors: G
authors: Luglio
authors: Stefania
authors: S
authors: Staibano
authors: Luigi
authors: L
authors: Bucci
authors: Dario
authors: D
authors: Esposito
authors: Francesco
authors: F
authors: Maione
authors: Massimo
authors: M
authors: Mascolo
authors: Gennaro
authors: G
authors: Ilardi
authors: Pietro
authors: P
authors: Forestieri
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D019793:Fluorescein; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D007432:Intraoperative Period; D008297:Male; D018613:Microscopy, Confocal / Q000295:instrumentation*; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D014741:Video Recording; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019793:Fluorescein