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Fluorescence Angiography in Colorectal Resection.

Eric K Johnson1, Mark O Hardin, Avery S Walker

  • 1Section of Colorectal Surgery, Department of Surgery, Madigan Army Medical Center, Tacoma, Washington.

Diseases of the Colon and Rectum
|December 10, 2015
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Summary

Intraoperative laser fluorescence angiography offers a novel approach for colorectal surgeons. This technique safely assesses vascular pedicle perfusion in complex oncologic resections, ensuring adequate blood flow to remaining bowel.

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Area of Science:

  • Colorectal surgery
  • Surgical oncology
  • Medical imaging technology

Background:

  • Intraoperative laser fluorescence angiography (iLFA) is emerging for assessing bowel perfusion post-resection.
  • Current applications focus on proximal bowel transection and anastomosis.
  • A novel application is proposed for complex cases involving major vascular pedicle assessment.

Purpose of the Study:

  • To describe a new application of iLFA in complex colorectal surgeries.
  • To evaluate its utility in assessing perfusion after major vascular pedicle transection.

Main Methods:

  • Technical note detailing a new use of iLFA.
  • Study conducted at a tertiary care military medical center.
  • Included patients undergoing oncologic colorectal resection with uncertain major vascular pedicle status.

Main Results:

  • iLFA provided adequate visualization and confirmed maintained perfusion after pedicle occlusion.
  • Oncologic resections were successfully performed.
  • Short-term outcomes were comparable to standard procedures.

Conclusions:

  • Early experience suggests iLFA is safe for assessing vascular perfusion in complex oncologic colorectal resections.
  • The technology may aid surgeons in critical decision-making regarding vascular pedicles.
  • Further investigation in a formal scientific setting is warranted.