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Yu Y, Wang Z, Gao S, Wu Y, Yu A, Wu F. Real-time visualization of skeletal muscle necrosis in mice and swine through NIR-II/I fluorescence imaging. JOURNAL OF BIOPHOTONICS 2024; 17:e202300225. [PMID: 37680010 DOI: 10.1002/jbio.202300225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023]
Abstract
Avulsion often occurs in the limb due to heavy shearing forces which not only damage skeletal muscle but also main vessels, resulting in life-threatening muscle ischemia and necrosis. Defining muscle activity is vital for surgical repair. Currently, the color, capacity of blood, contractibility, and consistency (4C) are the primary principles for evaluating the activities of torn muscles. Based on clinical experiences, this standard turns out to be delayed diagnosis, which is not defined by specific parameters. Recently, near-infrared (NIR) fluorescence probes emitting within the second near-infrared window (NIR-II, 1000-1700 nm) have been widely used for non-invasive optical imaging because the tissue absorption and autofluorescence in the NIR-II region are negligible, thus allowing deeper penetration depths with micrometer-scale spatial resolution in vivo. As pathogenesis and development of muscle necrosis, necrosis-related protein may participate in this procedure. There is promising future for NIR-II to be used in evaluating muscle activity in avulsion. A new approach is developed based on experiments with mice and large animals (swine). Myoblasts were incubated with indocyanine green (ICG) to identify the necrosis muscles. The model of extremity damaged muscle was established for the real-time visualization and detection of developed necrosis muscle field under new equipment, both in balb/c mice (female) and long-haired swines. A visible NIR-II/I imaging system was first used in a large animal injured skeletal muscle-related model. Our NIR-II/I imaging system is suitable for evaluating the normal and injured skeletal muscle ICG cycle and pointing to the necrotic skeletal muscle tissue. NIR-II imaging is superior to NIR-I imaging in estimating skeletal muscle, best with 1100 nm filter. NIR-II fluorescence with 1100 nm filter is suitable for analyzing the progress of necrosis muscle tissue, leading to a new approach for intraoperative evaluation.
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Affiliation(s)
- Yifeng Yu
- Department of Orthopedics, Renmin Hospital, Wuhan University, Wuhan, China
| | - Zheng Wang
- Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Siqi Gao
- Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Yifan Wu
- Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Aixi Yu
- Department of Orthopedics Trauma and Microsurgery, Zhongnan Hospital, Wuhan University, Wuhan, China
| | - Fei Wu
- Department of Orthopedics, Renmin Hospital, Wuhan University, Wuhan, China
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Kako T, Kimura M, Nomura R, Uehara S, Uematsu H, Nakaya S, Maeda Y, Tsuboi K, Harata K, Takiguchi S. A case of laparoscopic sigmoidectomy using thermography for colonic blood flow assessment. Surg Case Rep 2023; 9:170. [PMID: 37747603 PMCID: PMC10519892 DOI: 10.1186/s40792-023-01752-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Indocyanine green (ICG) fluorescence imaging is widely used in gastrointestinal surgery and is considered useful for reducing anastomotic leakage; however, because ICG remains in the tissue for a certain amount of time, we occasionally must re-evaluate colonic blood flow over a short time period during surgery. Herein, we verify the usefulness of thermography (TG) for evaluating colonic blood flow in a patient who underwent a laparoscopic sigmoidectomy for sigmoid colon cancer. CASE PRESENTATION The patient is 43-year-old man who underwent laparoscopic resection of the sigmoid colon for colon cancer. After vascular treatment of the colonic mesentery, ICG/TG identified the boundary between ischemic and non-ischemic colon tissues. An additional 2 cm of colonic mesentery was resected because of the presence of a diverticulum noted at the intended site of oral anastomosis when attaching the anvil head. After additional vascular treatment of the colonic mesentery and administration of ICG, fluorescence was observed in the colon; however, TG identified the zone of the temperature transition on the surface of the colonic mesentery, even after additional colonic mesentery resection in the same region as previously observed. This zone was used as the cut-off line. There were no complications, such as anastomotic leakage, after the surgery. CONCLUSION Although accumulation of similar cases is necessary, TG has the potential for use as an auxiliary diagnostic tool in clinical practice. TG can depict the presence or absence of blood flow based on surface temperature without the use of imaging agents, and is inexpensive and easy to perform.
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Affiliation(s)
- Tomohiro Kako
- Department of Gastroenterological Surgery, Nagoya City University East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi, Japan
- Department of Gastroenterological Surgery, Toyota Memorial Hospital, 1-1 Heiwa-cho, Toyota, Aichi, Japan
| | - Masahiro Kimura
- Department of Gastroenterological Surgery, Nagoya City University East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi, Japan.
| | - Ryo Nomura
- Department of Gastroenterological Surgery, Nagoya City University East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi, Japan
| | - Shuhei Uehara
- Department of Gastroenterological Surgery, Nagoya City University Hospital, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan
| | - Hiroshi Uematsu
- Department of Gastroenterological Surgery, Nagoya City University East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi, Japan
| | - Seiichi Nakaya
- Department of Gastroenterological Surgery, Nagoya City University Midori Municipal Hospital, 1-77 Shiomigaoka, Midori-ku, Nagoya, Aichi, Japan
| | - Yuzo Maeda
- Department of Gastroenterological Surgery, Nagoya City University East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi, Japan
| | - Ken Tsuboi
- Department of Gastroenterological Surgery, Nagoya City University East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi, Japan
| | - Koshiro Harata
- Department of Gastroenterological Surgery, Nagoya City University East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi, Japan
| | - Shuji Takiguchi
- Department of Gastroenterological Surgery, Nagoya City University Hospital, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan
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Skrzypczak P, Roszak M, Kasprzyk M, Dyszkiewicz W, Kamiński M, Gabryel P, Piwkowski C. The technique of stump closure has no impact on post-pneumonectomy bronchopleural fistula in the non-small cell lung cancer-a cross-sectional study. J Thorac Dis 2022; 14:3343-3351. [PMID: 36245618 PMCID: PMC9562551 DOI: 10.21037/jtd-22-240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 07/28/2022] [Indexed: 11/24/2022]
Abstract
Background Pneumonectomy is a high-risk radical resection procedure, with bronchopleural fistula (BPF) being its most challenging and severe complication. This study aimed to assess the surgical risk factors and the impact of the bronchial stump closure technique on the incidence of the BPF. Methods This is a single-center, cross-sectional study of the medical records of 455 post-pneumonectomy patients operated due to non-small cell lung cancer (NSCLC) in 2006-2017. We analyzed the following variables and their influence on the occurrence of the BPF: operation side, surgical techniques (i.e., manual suture or the stapler), stump buttressing, the extension of pneumonectomy, comorbidities, and postoperative complications. Results BPF occurred in 7.47% of post-pneumonectomy patients. BPF was more prevalent in right-sided pneumonectomy versus left-sided (10.98% vs. 5.32%; P=0.026). The use of a stapler or manual suture was not associated with the incidence of the BPF (7.96% vs.7.09%, P=0.72). There were no significant differences in the occurrence of BPF among bronchial stump buttressing with the parietal pleura (P=0.80), intercostal muscle flap (IMF) (P=0.46), and pericardial fat pad (P=0.88). When comparing data from 2006-2012 with those from 2013-2017, we found a steady decrease in the number of performed stump reinforcements, but this was not associated with a higher risk of BPF. Conclusions The method used for stump closure, additional tissue buttressing of the bronchial stump and year of the surgery had no significant impact on the occurrence of BPF. Only right-sided pneumonectomy was associated with higher BPF occurrence.
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Affiliation(s)
- Piotr Skrzypczak
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznań, Poland
| | - Mariusz Kasprzyk
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Wojciech Dyszkiewicz
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Mikołaj Kamiński
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Piotr Gabryel
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
| | - Cezary Piwkowski
- Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznań, Poland
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Han T, Sun B, Wang W, Cui J, Shen W. The Role of ICG Angiography in Decision Making About Skin-Sparing in Pediatric Acute Trauma. Front Pediatr 2022; 10:851270. [PMID: 35372153 PMCID: PMC8967320 DOI: 10.3389/fped.2022.851270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 02/01/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Indocyanine green (ICG) angiography has proven useful in assessing skin flap perfusion in plastic and reconstructive surgeries. This research aimed to explore its role in decision making about skin-sparing in children's acute trauma. METHODS A total of 19 patients suffering with acute trauma from January 2019 to September 2021 were retrospectively assessed. Both ICG angiography and clinical judgment were performed to evaluate skin tissue viability. The intraoperative decisions for each case depended on the specific condition of the traumatic wound, including tissue perfusion, skin defect area, and location of the wound. Postoperative vascular imaging software was used to quantify the tissue perfusion, and the duration of postoperative follow-up was from 6 to 18 months. RESULTS Among them, 18 (94.7%) patients experienced treatments according to ICG angiography and did not develop postoperative necrosis. One case with right forearm trauma suffered from partial necrosis. Hypertrophic scar and local infection were the independent complications, which were managed by symptomatic treatment. CONCLUSION ICG angiography may reduce the risk of postoperative necrosis and renders a promising adjunctive technique for surgeons to make reasonable decisions in skin sparing in acute pediatric trauma.
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Affiliation(s)
- Tao Han
- Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Buhao Sun
- Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Weidong Wang
- Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Jie Cui
- Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Weimin Shen
- Department of Burns and Plastic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
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Tsukioka T, Izumi N, Komatsu H, Inoue H, Matsuda Y, Ito R, Kimura T, Miki Y, Nishiyama N. Changes in pedicle pericardial fat tissue around the anastomotic site after tracheobronchoplasty. Surg Today 2021; 52:414-419. [PMID: 34468845 DOI: 10.1007/s00595-021-02370-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/10/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Pericardial fat is appropriate tissue to cover the bronchial anastomotic site because its harvesting is minimally invasive. We investigated the changes in pericardial fat tissue around the anastomotic site after pulmonary resection with tracheobronchoplasty. METHODS The subjects of this study were 43 lung cancer patients who underwent pulmonary resection with tracheobronchoplasty. We measured the maximum cross-sectional area and average computed tomography (CT) values of the pedicle pericardial fat pad around the anastomotic site 1 week and then 6 months after the operation. RESULTS The average volume of the residual pedicle pericardial fat pad 6 months postoperatively was 61%. A body mass index (BMI) < 21.2 kg/m2 (P = 0.031) and a blood albumin level < 3.4 g/dl (P = 0.005) were significant predictors of pedicle flap shrinkage. Patients with fat tissue shrinkage had significantly elevated CT values 6 months postoperatively (P = 0.029), whereas those without shrinkage maintained low CT values. CONCLUSIONS Preoperative nutritional conditions, reflected in high BMI and blood albumin levels, correlated with a high residual pedicle pericardial fat pad. Conversely, patients with pedicle flap shrinkage had significantly increased CT values, suggesting that the fat might have taken on another form such as scar tissue.
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Affiliation(s)
- Takuma Tsukioka
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
| | - Nobuhiro Izumi
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hiroaki Komatsu
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hidetoshi Inoue
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yumi Matsuda
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Ryuichi Ito
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Takuya Kimura
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Noritoshi Nishiyama
- Department of General Thoracic Surgery, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
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Cameron RB. Commentary: Bronchopleural Fistulae: Are Fibroblasts Necessarily the Real Answer? Semin Thorac Cardiovasc Surg 2021; 34:361-362. [PMID: 34004311 DOI: 10.1053/j.semtcvs.2021.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/28/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Robert B Cameron
- Division of Thoracic Surgery, Department of Surgery, David Geffen School of Medicine at UCLA and the Division of Thoracic Surgery, Department of Surgery and Perioperative Care, West Los Angeles VA Medical Center, Los Angeles, California.
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Kawamoto N, Okita R, Hayashi M, Suetake R, Murakami T, Inokawa H. Intraoperative bronchial blood flow evaluation using indocyanine green fluorescence for bronchoplasty: A case report. Int J Surg Case Rep 2021; 80:105684. [PMID: 33639501 PMCID: PMC7921497 DOI: 10.1016/j.ijscr.2021.105684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 11/04/2022] Open
Abstract
Indocyanine green fluorescence (ICG-FL) detects blood flow of the bronchial artery. ICG-FL is effective for blood flow evaluation after bronchial artery embolization. Bronchial blood flow evaluation may reduce the risk of anastomotic leakage.
Introduction and importance Blood flow evaluation of bronchial arteries using indocyanine green fluorescence (ICG-FL) is rarely reported during pulmonary resection. We present the case of a patient with bronchiectasis and a history of bronchial artery embolization (BAE) for hemoptysis. Bronchial artery blood flow was evaluated using ICG-FL during lobectomy with bronchoplasty. Case presentation A 63-year-old woman presented with right middle lobe bronchiectasis (due to nontuberculous mycobacteriosis) and repeated hemoptysis, which had previously been corrected each time with hemostasis by BAE. Bronchoscopy revealed a swollen blood vessel proximal to the right middle lobe bronchus that was suspected of being the origin of bleeding. Right middle lobectomy with bronchoplasty was performed to prevent hemoptysis. ICG-FL was used to detect the patency of the right bronchial arteries, and the arteries surrounding the right middle lobe bronchus were ligated. The proximal side of the right middle lobe bronchus was cut in a deep wedge shape, and the bronchus was anastomosed. ICG-FL revealed that the blood supply was maintained at the bronchial anastomosis. No bronchial anastomotic leakage was observed after the surgery. Clinical discussion The key to successful bronchoplasty is the maintenance of blood flow. Bronchial artery blood flow theoretically decreases after BAE. In this case, ICG-FL was able to detect bronchial artery patency before cutting the bronchus as well as the maintenance of blood flow at the bronchial anastomosis after bronchoplasty. Conclusion Intraoperative blood flow evaluation of the bronchus using ICG-FL may reduce the risk of bronchial anastomotic leakage caused by ischemia after bronchoplasty.
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Affiliation(s)
- Nobutaka Kawamoto
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan.
| | - Riki Okita
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan
| | - Masataro Hayashi
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan
| | - Ryo Suetake
- Department of Respiratory Medicine, National Hospital Organization Yamaguchi Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan
| | - Tomoyuki Murakami
- Department of Clinical Research, National Hospital Organization Yamaguchi Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan; Department of Pathology, National Hospital Organization Kanmon Medical Center, 1-1 Chofusotoura-cho, Shimonoseki, Yamaguchi 752-8510, Japan
| | - Hidetoshi Inokawa
- Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan
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Meyer A, Roof S, Gray ML, Fan CJ, Barber B, Miles BA, Teng M, Genden E, Rosenberg JD. Thermal imaging for microvascular free tissue transfer monitoring: Feasibility study using a low cost, commercially available mobile phone imaging system. Head Neck 2020; 42:2941-2947. [DOI: 10.1002/hed.26350] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 05/10/2020] [Accepted: 06/09/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Annika Meyer
- Department of Otolaryngology—Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Scott Roof
- Department of Otolaryngology—Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Mingyang L. Gray
- Department of Otolaryngology—Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Caleb J. Fan
- Department of Otolaryngology—Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Brittany Barber
- Department of Otolaryngology—Head and Neck Surgery University of Washington Seattle Washington USA
| | - Brett A. Miles
- Department of Otolaryngology—Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Marita Teng
- Department of Otolaryngology—Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Eric Genden
- Department of Otolaryngology—Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
| | - Joshua D. Rosenberg
- Department of Otolaryngology—Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA
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