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Journal of Biomedical Optics

Optical fiber probe spectroscopy for laparoscopic monitoring of tissue oxygenation during esophagectomies
Author(s): Daniel S. Gareau; Frederic Truffer; Kyle Perry; Thai Pham; C. Kristian Enestvedt; James Dolan; John G. Hunter; Steven L. Jacques
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Paper Abstract

Anastomotic complication is a major morbidity associated with esophagectomy. Gastric ischemia after conduit creation contributes to anastomotic complications, but a reliable method to assess oxygenation in the gastric conduit is lacking. We hypothesize that fiber optic spectroscopy can reliably assess conduit oxygenation, and that intraoperative gastric ischemia will correlate with the development of anastomotic complications. A simple optical fiber probe spectrometer is designed for nondestructive laparoscopic measurement of blood content and hemoglobin oxygen saturation in the stomach tissue microvasculature during human esophagectomies. In 22 patients, the probe measured the light transport in stomach tissue between two fibers spaced 3-mm apart (500- to 650-nm wavelength range). The stomach tissue site of measurement becomes the site of a gastroesophageal anastamosis following excision of the cancerous esophagus and surgical ligation of two of the three gastric arteries that provide blood perfusion to the anastamosis. Measurements are made at each of five steps throughout the surgery. The resting baseline saturation is 0.51±0.15 and decreases to 0.35±0.20 with ligation. Seven patients develop anastomotic complications, and a decreased saturation at either of the last two steps (completion of conduit and completion of anastamosis) is predictive of complication with a sensitivity of 0.71 when the specificity equaled 0.71.

Paper Details

Date Published: 1 November 2010
PDF: 6 pages
J. Biomed. Opt. 15(6) 061712 doi: 10.1117/1.3512149
Published in: Journal of Biomedical Optics Volume 15, Issue 6
Show Author Affiliations
Daniel S. Gareau, Oregon Health & Science Univ. (United States)
Frederic Truffer, Oregon Health & Science Univ. (United States)
Kyle Perry, Oregon Health & Science Univ. (United States)
Thai Pham, Oregon Health & Science Univ. (United States)
C. Kristian Enestvedt, Oregon Health & Science Univ. (United States)
James Dolan, Oregon Health & Science Univ. (United States)
John G. Hunter, Oregon Health & Science Univ. (United States)
Steven L. Jacques, Oregon Health & Science Univ. (United States)

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