Visualization of the Stomach's Arterial Networks During Esophageal Surgery Using the HyperEye Medical System.
OBJECTIVE
The present study investigated the visualization of the arterial networks in the stomach (ANS) during gastric tube (GT) creation using indocyanine green fluorescence and the HyperEye Medical System (HEMS), and the feasibility of the HEMS-line-marking method (LMM).


METHODS
We reviewed 51 consecutive patients who had undergone esophageal surgery with GT reconstruction. Patients for whom the HEMS was deployed after GT creation to confirm the anastomosed area's blood supply formed the control group (n=28). Patients for whom the HEMS was deployed before GT creation to confirm and mark the ANS border comprised the HEMS-LMM group (n=23).


RESULTS
The HEMS-LMM visualized the ANS border, and the leakage rate decreased from 17.9% to 4.4% (p=0.204).


CONCLUSIONS
The HEMS-LMM is safe and feasible for visualizing the blood supply border of the right gastroepiploic artery and the ANS before GT creation during esophageal surgery, and it might reduce leakage in esophageal surgery.
Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan.
Hiroyuki
H
Kitagawa
Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan tsutomun@kochi-u.ac.jp.
Tsutomu
T
Namikawa
Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan.
Masaya
M
Munekage
Department of Surgery, Kochi Hata Prefectural Hospital, Yamanacho, Sukumo, Kochi, Japan.
Toyokazu
T
Akimori
Department of Human Health and Medical Sciences, Kochi Medical School, Nankoku, Kochi, Japan.
Michiya
M
Kobayashi
Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan.
Kazuhiro
K
Hanazaki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000473:pathology*; D016022:Case-Control Studies; D004396:Coloring Agents / Q000493:pharmacokinetics; D004938:Esophageal Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D004944:Esophagoplasty; D004947:Esophagus / Q000473:pathology; D005240:Feasibility Studies; D005260:Female; D005456:Fluorescent Dyes / Q000493:pharmacokinetics; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061848:Optical Imaging / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply*; D014018:Tissue Distribution
D004396:Coloring Agents; D005456:Fluorescent Dyes; D007208:Indocyanine Green
HyperEye medical system; Indocyanine green fluorescence; gastric tube; line-marking method