TY - JOUR
T1 - Fluorescence-based bowel anastomosis perfusion evaluation
T2 - results from the IHU-IRCAD-EAES EURO-FIGS registry
AU - Spota, Andrea
AU - Al-Taher, Mahdi
AU - Felli, Eric
AU - Morales Conde, Salvador
AU - Dal Dosso, Ivano
AU - Moretto, Gianluigi
AU - Spinoglio, Giuseppe
AU - Baiocchi, Gianluca
AU - Vilallonga, Ramon
AU - Impellizzeri, Harmony
AU - Martin-Martin, Gonzalo P.
AU - Casali, Lorenzo
AU - Franzini, Christian
AU - Silvestri, Marta
AU - de Manzini, Nicolo
AU - Castagnola, Maurizio
AU - Filauro, Marco
AU - Cosola, Davide
AU - Copaescu, Catalin
AU - Garbarino, Giovanni Maria
AU - Pesce, Antonio
AU - Calabro, Marcello
AU - de Nardi, Paola
AU - Anania, Gabriele
AU - Carus, Thomas
AU - Boni, Luigi
AU - Patane, Alessandro
AU - Santi, Caterina
AU - Saadi, Alend
AU - Rollo, Alessio
AU - Chautems, Roland
AU - Noguera, Jose
AU - Grosek, Jan
AU - D'Ambrosio, Giancarlo
AU - Ferreira, Carlos Marques
AU - Norcic, Gregor
AU - Navarra, Giuseppe
AU - Riva, Pietro
AU - Quaresima, Silvia
AU - Paganini, Alessandro
AU - Rosso, Nunzio
AU - De Paolis, Paolo
AU - Balla, Andrea
AU - Sauvain, Marc Olivier
AU - Gialamas, Eleftherios
AU - Bianchi, Giorgio
AU - La Greca, Gaetano
AU - Castoro, Carlo
AU - Picchetto, Andrea
AU - Franchello, Alessandro
AU - Tartamella, Luciano
AU - Juvan, Robert
AU - Ioannidis, Orestis
AU - Kosir, Jurij Ales
AU - Bertani, Emilio
AU - Stassen, Laurents
AU - Marescaux, Jacques
AU - Diana, Michele
N1 - Funding Information:
Michele Diana is the PI and the recipient of the ELIOS grant from the ARC foundation and is member of the Advisory Board of Diagnostic Green. Salvador Morales Conde reports grants and other relationships with Medtronic and other relationships with BD Bard, Ethicon, Olympus, Storz, Stryker, Dipro, Baxter, and BBraum, outside the submitted work. Gianluca Baiocchi reports paid consultation for Stryker corp and travel grant from Karl Storz and from Stryker corp. Luigi Boni played a role as consultant for company producing fluorescent-guided surgery devices. Laurents Stassen reports other relationships with Diagnostic Green, outside the submitted work. Jacques Marescaux is the President of the IRCAD, which is partly funded by KARL STORZ and Medtronic. Andrea Spota, Mahdi Al-Taher, Eric Felli, Ivano Dal Dosso, Gianluigi Moretto, Giuseppe Spinoglio, Ramon Vilallonga, Harmony Impellizzeri, Gonzalo P. Martin-Martin, Lorenzo Casali, Christian Franzini, Marta Silvestri, Nicolò de Manzini, Maurizio Castagnola, Marco Filauro, Davide Cosola, Catalin Copaescu, Giovanni Maria Garbarino, Antonio Pesce, Marcello Calabrò, Paola De Nardi, Gabriele Anania, Thomas Carus, Alessandro Patanè, Caterina Santi, Alend Saadi, Alessio Rollo, Roland Chautems, José Noguera, Jan Grosek, Giancarlo D’Ambrosio, Carlos Marques Ferreira, Gregor Norcic, Giuseppe Navarra, Pietro Riva, Silvia Quaresima, Alessandro Paganini, Nunzio Rosso, Paolo De Paolis, Andrea Balla, Marc-Olivier Sauvain, Eleftherios Gialamas, Giorgio Bianchi, Gaetano La Greca, Carlo Castoro, Andrea Picchetto, Alessandro Franchello, Luciano Tartamella, Robert Juvan, Orestis Ioannidis, Jurij Ales Kosir, and Emilio Bertani have no conflicts of interest or financial ties to disclose.
Funding Information:
In order to collect high-volume data, share experiences about the current practices of NIRF imaging across Europe and facilitate collaborations among surgical centers, a European registry on Fluorescence Image-Guided Surgery (EURO-FIGS: www.euro-figs.eu ) has been launched. This registry is a collaboration between the Research Institute against Digestive Cancer (IRCAD, Strasbourg), the Institute of Image-Guided Surgery (IHU-Strasbourg), and the Technology Committee of the European Association of Endoscopic Surgery (EAES) and is funded by the Association for Cancer Research (ARC, France). At the moment, the registry is collecting data on the following: (I) near-infrared cholangiography of which the preliminary results were published in 2019 []; (II) anastomotic perfusion evaluation (III) fluorescence-based lymphography; data collection on additional clinical applications will be added soon.
Funding Information:
The EURO-FIGS registry is funded by a grant from the ARC Foundation for Cancer Research (9, rue Guy Môquet; 94803 Villejuif Cedex, France, www.fondation-arc.org ), within the framework of the ELIOS (Endoscopic Luminescent Imaging for precision Oncologic Surgery) project.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
PY - 2021/12
Y1 - 2021/12
N2 - Background Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Near-infrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry. Methods Analysis of data prospectively collected by the registry members provided patient and procedural data along with the ICG dose, timing, and consequences of NIRF imaging. Among the included upper-GI, colorectal, and bariatric surgeries, subgroup analysis was performed to identify risk factors associated with complications. Results A total of 1240 patients were included in the study. The included patients, 74.8% of whom were operated on for cancer, originated from 8 European countries and 30 hospitals. A total of 54 surgeons performed the procedures. In 83.8% of cases, a pre-anastomotic ICG dose was administered, and in 60.1% of cases, a post-anastomotic ICG dose was administered. A significant difference (p < 0.001) was found in the ICG dose given in the four pathology groups registered (range: 0.013-0.89 mg/kg) and a significant (p < 0.001) negative correlation was found between the ICG dose and BMI. In 27.3% of the procedures, the choice of the anastomotic level was guided by means of NIRF imaging which means that in these cases NIRF imaging changed the level of anastomosis which was first decided based on visual findings in conventional white light imaging. In 98.7% of the procedures, the use of ICG partly or strongly provided a sense of confidence about the anastomosis. A total of 133 complications occurred, without any statistical significance in the incidence of complications in the anastomoses, whether they were ICG-guided or not. Conclusion The EURO-FIGS registry provides an insight into the current clinical practice across Europe with respect to NIRF imaging of anastomotic perfusion during digestive tract surgery.
AB - Background Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Near-infrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry. Methods Analysis of data prospectively collected by the registry members provided patient and procedural data along with the ICG dose, timing, and consequences of NIRF imaging. Among the included upper-GI, colorectal, and bariatric surgeries, subgroup analysis was performed to identify risk factors associated with complications. Results A total of 1240 patients were included in the study. The included patients, 74.8% of whom were operated on for cancer, originated from 8 European countries and 30 hospitals. A total of 54 surgeons performed the procedures. In 83.8% of cases, a pre-anastomotic ICG dose was administered, and in 60.1% of cases, a post-anastomotic ICG dose was administered. A significant difference (p < 0.001) was found in the ICG dose given in the four pathology groups registered (range: 0.013-0.89 mg/kg) and a significant (p < 0.001) negative correlation was found between the ICG dose and BMI. In 27.3% of the procedures, the choice of the anastomotic level was guided by means of NIRF imaging which means that in these cases NIRF imaging changed the level of anastomosis which was first decided based on visual findings in conventional white light imaging. In 98.7% of the procedures, the use of ICG partly or strongly provided a sense of confidence about the anastomosis. A total of 133 complications occurred, without any statistical significance in the incidence of complications in the anastomoses, whether they were ICG-guided or not. Conclusion The EURO-FIGS registry provides an insight into the current clinical practice across Europe with respect to NIRF imaging of anastomotic perfusion during digestive tract surgery.
KW - Fluorescence-guided surgery
KW - Image-guided surgery
KW - Near-infrared fluorescence imaging
KW - Registry
KW - INDOCYANINE GREEN
KW - RISK-FACTORS
KW - COLORECTAL-SURGERY
KW - RESECTION
KW - CANCER
KW - ESOPHAGECTOMY
KW - LEAKAGE
KW - CONSEQUENCES
KW - ENHANCED REALITY
KW - COMPLICATIONS
U2 - 10.1007/s00464-020-08234-8
DO - 10.1007/s00464-020-08234-8
M3 - Article
C2 - 33492508
SN - 0930-2794
VL - 35
SP - 7142
EP - 7153
JO - Surgical endoscopy and other interventional techniques
JF - Surgical endoscopy and other interventional techniques
IS - 12
ER -