Background: Compromised perfusion as a result of surgical intervention causes a reduction of oxygen and nutrients in tissue and therefore decreased tissue vitality. Quantitative imaging of tissue perfusion during reconstructive surgery, therefore, may reduce the incidence of complications. Non-invasive optical techniques allow real-time tissue imaging, with high resolution and high contrast. The objectives of this study are, first, to assess the feasibility and accuracy of optical coherence tomography (OCT), sidestream darkfield microscopy (SDF), laser speckle contrast imaging (LSCI), and fluorescence imaging (FI) for quantitative perfusion imaging and, second, to identify/search for criteria that enable risk prediction of necrosis during gastric tube and free flap reconstruction.
Methods: This prospective, multicenter, observational in vivo pilot study will assess tissue perfusion using four optical technologies: OCT, SDF, LSCI, and FI in 40 patients: 20 patients who will undergo gastric tube reconstruction after esophagectomy and 20 patients who will undergo free flap surgery. Intra-operative images of gastric perfusion will be obtained directly after reconstruction at four perfusion areas. Feasibility of perfusion imaging will be analyzed per technique. Quantitative parameters directly related to perfusion will be scored per perfusion area, and differences between biologically good versus reduced perfusion will be tested statistically. Patient outcome will be correlated to images and perfusion parameters. Differences in perfusion parameters before and after a bolus of ephedrine will be tested for significance.
Discussion: This study will identify quantitative perfusion-related parameters for an objective assessment of tissue perfusion during surgery. This will likely allow early risk stratification of necrosis development, which will aid in achieving a reduction of complications in gastric tube reconstruction and free flap transplantation.
Trial Registration: Clinicaltrials.gov registration number NCT02902549. Dutch Central Committee on Research Involving Human Subjects registration number NL52377.018.15.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702143 | PMC |
| http://dx.doi.org/10.1186/s40814-017-0204-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The benefits of contrast-enhanced ultrasound in the differential diagnosis of suspicious breast lesions.
Front Med (Lausanne)
December 2024
Department of Ultrasound, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Background: Contrast-enhanced ultrasound (CEUS) shows potential for the differential diagnosis of breast lesions in general, but its effectiveness remains unclear for the differential diagnosis of lesions highly suspicious for breast cancers.
Objective: This study aimed to evaluate the diagnostic value of CEUS in differentiating pathological subtypes of suspicious breast lesions defined as category 4 of US-BI-RADS.
Methods: The dataset of 150 breast lesions was prospectively collected from 150 patients who underwent routine ultrasound and CEUS examination and were highly suspected of having breast cancers.
Secondary insults prevalence, co-occurrence and relationship with outcome after severe TBI.
Brain Spine
February 2024
Brain Physics Laboratory Division of Neurosurgery Department of Clinical Neurosciences, University of Cambridge, UK.
Introduction: Secondary insults due to high intracranial pressure (ICP), low cerebral perfusion pressure (CPP) and impaired cerebral pressure reactivity (PRx) predict outcome after severe traumatic brain injury (TBI).
Research Question: What is the prevalence, co-occurrence and prognostic importance of secondary insults due to deranged ICP, CPP or PRx after TBI.
Material And Methods: Severe TBI patients requiring ICP monitoring were included.
Severe respiratory alkalosis in a patient with aphasia: an uncommon stroke mimic?
Neurol Sci
January 2025
Second Department of Neurology, National & Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
Impact of Microcirculatory Dysfunction on Persistent Global Cerebral Edema After Aneurysmal Subarachnoid Hemorrhage: An Age-Stratified Analysis.
Neurocrit Care
January 2025
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119 South 4th Ring West Road, Fengtai District, Beijing, China.
Background: Microcirculatory dysfunction is one of the most important pathophysiology mechanisms of global cerebral edema (GCE) after aneurysmal subarachnoid hemorrhage (aSAH). Data regarding the impact of microcirculatory dysfunction on persistent GCE following aSAH are currently lacking. The aim of our study was to investigate whether microcirculatory dysfunction is correlated with persistent GCE in patients with aSAH across different age groups.
View Article and Find Full Text PDFCerebral Protection in Pediatric Cardiac Surgery.
Pediatr Cardiol
January 2025
Service of Cardiac Surgery, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Cardiac surgery, both adult and pediatric, has developed very rapidly and impressively over the past 7 decades. Pediatric cardiac surgery, in particular, has revolutionized the management of babies born with congenital heart disease such that now most patients reach adult life and lead comfortable lives. However, these patients are at risk of cerebral lesions, which may be due to perioperative factors, such as side effects of cardiopulmonary bypass and/or anesthesia, and non-perioperative factors such as chromosomal anomalies (common in children with congenital heart disease), the timing of surgery, number of days on the intensive care unit, length of hospitalization and other hospitalizations in the first year of life.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!