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Proceedings Paper

Intraoperative assessment of microperfusion with visible light spectroscopy in oesophageal and colorectal anastomosis
Author(s): Anne Karliczek; David A. Benaron; Peter Baas; Anne van der Stoel; Theo Wiggers; John Plukker; Gooitzen M. van Dam
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Paper Abstract

In gastrointestinal surgery, leakage of anastomoses in general is a challenging problem because of the related mortality and morbidity1,2. The highest incidence of anastomotic leakage is found at the most proximal and most distal parts of the digestive tract, i.e. esophageal and colorectal anastomoses. Increased strain and limited vascular supply at the anastomoses are the two main reasons of leakage, especially in the absence of a serosal layer at these sites2,3,4. Apart from these local risk factors, several general risk factors attributed to the occurrence of anastomotic failure, of which smoking, cardiovascular disease, gender, age and malnutrition are the most important2,5-8. Most of these factors suggest local ischemia as an important cause of anastomotic dehiscence. In esophageal resection the blood supply to the remaining esophageal end is compromised due to ligation of arteries and resection of surrounding mediastinal tissue. Furthermore, the gastric conduit, usually only based on the right gastroepiploic artery, is transposed from its anatomical abdominal position into the thoracic cavity and cervical region. Apart from co-existing morbidities such as sepsis, cardiovascular and several systemic diseases, the altered vascular supply frequently compromises the microcirculation at both ends of the anastomosis, and is as such responsible for the higher rate of leakage compared to small and other large bowel anastomoses9,10.

Paper Details

Date Published: 19 July 2007
PDF: 9 pages
Proc. SPIE 6628, Diagnostic Optical Spectroscopy in Biomedicine IV, 66280E (19 July 2007); doi: 10.1117/12.725024
Show Author Affiliations
Anne Karliczek, Groningen Univ. Medical Ctr. (Netherlands)
Martini Hospital (Netherlands)
David A. Benaron, Spectros Corp. (United States)
Peter Baas, Martini Hospital (Netherlands)
Anne van der Stoel, Martini Hospital (Netherlands)
Theo Wiggers, Groningen Univ. Medical Ctr. (Netherlands)
John Plukker, Groningen Univ. Medical Ctr. (Netherlands)
Gooitzen M. van Dam, Groningen Univ. Medical Ctr. (Netherlands)


Published in SPIE Proceedings Vol. 6628:
Diagnostic Optical Spectroscopy in Biomedicine IV
Dietrich Schweitzer; Maryann Fitzmaurice, Editor(s)

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