EVALUATION OF GASTRIC CONDUIT PERFUSION RESULTS BASED ON REAL-TIME INDOCYANINE GREEN FLOW SIGNAL IN THORACOSCOPIC SURGERY FOR ESOPHAGEAL CANCER

Tóm tắt

Objectives: To evaluate gastric conduit perfusion (GCP) images based on indocyanine green (ICG) flow signal timing in thoracoscopic surgery for esophageal cancer (EsC). Methods: A cross-sectional descriptive study was conducted on 70 patients who were applied ICG to evaluate GCP during thoracoscopic surgery to treat EsC at 108 Military Central Hospital and Military Hospital 103 from June 2022 to June 2024. Results: The mean age was 59.0 ± 7.9 (32 - 71) years old; 100% were male. The anastomotic leak rate was 7.1%, with a mean gastric conduit (GC) width of 5.1 ± 0.2cm. Through ICG imaging, 17 patients with missing GC were detected. The average ischemic GC length was 2.7 ± 0.6cm. The time of appearance of the ICG signal in segments (B-C) and segments (A-D) of the anastomotic leak group was longer than that of the group without anastomotic leak (p < 0.05). Multivariable logistic regression analysis found that the greater the rate of ischemic GC, the higher the anastomotic leak rate (OR = 59.27; 95%CI= 1.25 - 2802.03; p = 0.04). Conclusion: Evaluation of GCP images based on ICG flow signal timing is feasible, safe, and objective. ICG current signal timing helps detect the location of the poorly perfused GC and select the appropriate location to create the anastomosis with a low anastomotic leak rate.