According to a recent study, indocyanine green (ICG) fluorescence imaging can aid in the visualization of intestinal blood flow during laparoscopic surgery for strangulated colon blockage.
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The study included fourteen patients (median age 72.7
years, 64.3 percent men). After the reduction of an adhesion or hernia incarceration, small bowel color tone and peristalsis were examined under
normal-light settings while under laparoscopic surgery. Then, using a
near-infrared imaging instrument, 5 mg of ICG was injected into a peripheral
vein and viewed.
The findings of both normal-light and near-infrared
imaging were used to determine the final surgical plan (intestinal resection or
preservation). The degree of intestinal necrosis was measured in the resection
group, while postoperative problems were measured in the preservation group.
Four individuals qualified for resection after
normal-light and near-infrared assessments, all of whom were determined to have
necrosis. In all four patients, the intestinal wall was discolored black
without perforation, and ICG fluorescence was barely discernible.
The ten patients who were advised for intestinal preservation, on the other hand, had a significant reduction in dark red
coloration when the strangulation was removed, but their intestinal wall
appearance was diverse. In these ten cases, ICG fluorescence was clearly
apparent at a median time of 39.5 seconds. There were no problems such as
delayed perforation or gastrointestinal stricture.
“ICG fluorescence imaging may be a useful new source
of evidence for improving intraoperative judgment in surgery for strangulated
intestinal blockage. To clarify our findings, more evidence from trials with
bigger patient groups is needed, according to the researchers.
Source: Asian J Surg
2021;doi:10.1016/j.asjsur.2021.08.020