title: Intraoperative free jejunum flap monitoring with indocyanine green near-infrared angiography.
abstract: The free jejunum flap technique has been regarded as the optimal approach during circumferential pharyngolaryngectomy reconstruction. Although classical patency tests are available, an intraoperative guarantee of the patency of anastomoses and microcirculations is inevitable. Indocyanine green near-infrared angiography (ICGA) was intraoperatively performed in six patients after reconstruction using the free jejunum flap. An adequate arterial as well as venous phase was observed. In addition to classical patency tests and doppler, we have successfully monitored the flap after total pharyngolalyngectomy intraoperatively using the ICGA. Our preliminary results implicate that this novel technique offers secure intraoperative monitoring of a free jejunum graft. This technique will provide us with advantages over regular patency test in selected cases.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kanazawa University, Kanazawa, Ishikawa, 920-8640, Japan, murono@med.kanazawa-u.ac.jp.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Murono
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ishikawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtake
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuji
authors.forename: Kazuhira
authors.initials: K
authors.lastname: Endo
authors.forename: Satoru
authors.initials: S
authors.lastname: Kondo
authors.forename: Naohiro
authors.initials: N
authors.lastname: Wakisaka
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Yoshizaki
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D001158:Arteries / Q000601:surgery; D005451:Fluorescein Angiography / Q000295:instrumentation*; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007208:Indocyanine Green; D007275:Injections, Intravenous; D007583:Jejunum / Q000098:blood supply* / Q000637:transplantation*; D007825:Laryngectomy / Q000379:methods*; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D037981:Neck Dissection; D010614:Pharynx / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis*; D014654:Vascular Patency / Q000502:physiology; D014680:Veins / Q000601:surgery
chemical_list: D007208:Indocyanine Green