マサムネ ケン   MASAMUNE Ken
  正宗 賢
   所属   研究施設 研究施設
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Clinical efficacy of bowel perfusion assessment during laparoscopic colorectal resection using laser speckle contrast imaging: A matched case–control study
掲載誌名 正式名:Asian Journal of Endoscopic Surgery
ISSNコード:17585910
掲載区分国内
巻・号・頁 e12759頁
著者・共著者 KOJIMA Shigehiro †, SAKAMOTO Tsuguo, MATSUI Yutaka, NAMBU Kyojiro, MASAMUNE Ken
発行年月 2019/11/05
概要 Abstract
Introduction
Disadvantages of bowel perfusion assessment with indocyanine green fluorescence angiography include the need for a fluorophore and the subjective nature of the assessment. This study was performed to evaluate the clinical efficacy of bowel perfusion assessment using laser speckle contrast imaging (LSCI) during laparoscopic colorectal surgery.
Methods
The study population comprised the first 27 consecutive patients who underwent laparoscopic left‐sided colorectal resection with intraoperative perfusion assessment using LSCI. The operative outcomes of these patients were compared with those of a matched group of patients without perfusion assessment. We analyzed the flux data expressed in laser speckle perfusion units.
Results
After propensity score matching, we found no significant between‐group differences in the patients' characteristics with the exception of the cancer stage. No patients undergoing LSCI perfusion assessment developed anastomotic leakage, but five (18.5%) patients in the control group did, at a significantly higher rate in male patients (P = .042). There were no significant differences in other operative outcomes. The laser speckle perfusion unit values after ligating marginal vessels were significantly lower than before ligation (P < .01).
Conclusions
With respect to anastomotic leakage, LSCI may improve patient outcomes after colorectal surgery. This technique appears to be a superior tool with the advantages of measurement repeatability and quantitativity and no need for a fluorophore.
DOI 10.1111/ases.12759