The quality of intestinal blood supply is extremely important for healing of intestinal anastomoses. During the surgery the blood supply of the intestine may appear sufficient even though the microperfusion is not fully adequate. The degree of blood supply of remaining intestinal segment and the positioning of the resection margins is estimated subjectively by the surgeon's experience or objectively by means of indocyanine green fluorescence imaging. The subject of our study is the evaluation of the infrared thermal imaging as another supportive non-invasive imaging method in assessment of intestinal blood supply, and to compare surgeon's decisions of the position of resection line with information obtained by infrared thermal imaging and by indocyanine green fluorescence imaging.
A pilot study on thermal imaging measurements was done in a porcine model. The infrared thermocamera Workswell WIC 640 was used in our study. The thermal imaging was correlated with the indocyanine green imaging method ICG NOVADAQ and with surgeon's subjective expert decisions of the places of resection lines. Fifteen monitored resections were performed on three experimental porcine models.
Based on the data evaluated, experience of the surgical team and the post-operative conditions of the porcine models, we conclude that the thermal imaging is a useful tool for determination of the optimal intestinal resection margins, and thus contributes to lowering anastomotic complications rate in colorectal surgery. The results show relatively high consistency between the used imaging techniques. Both methods showed ischemic regions of the intestine at a comparable level. The IRT methods showed even a slightly higher match with the surgeon's rating.
Based on experiments, the infrared thermography can be considered as one of complementary imaging methods suitable for use during anastomosis surgery. The sensitivity and versatility of the infrared thermography method was demonstrated. There was confirmed agreement in obtained information about the position of area with maximal blood insufficiency obtained by IRT with the information obtained by using the ICG method.Le texte complet de cet article est disponible en PDF.
The Infrared thermography and indocyanine green imaging methods were compared.
Observing of resection line by infrared thermocamera was realized.
The infrared thermography was described as a complementary imaging methods.
Keywords : Anastomosis, Indocyanine green fluorescence imaging, Intestine surgery, Infrared thermography imaging, Resection