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Intraoperative verification of colorectal anastomotic integrity


Authors: L. Martínek 1;  R. Bergamaschi 2;  J. Hoch 1
Authors‘ workplace: Chirurgická klinika 2. LF UK v Praze a Fakultní nemocnice Motol, přednosta: prof. MUDr. J. Hoch, CSc. 1;  Division of Colon and Rectal Surgery, University of New York, Stony Brook, chief of division: prof. MD R. Bergamaschi, PhD. 2
Published in: Rozhl. Chir., 2015, roč. 94, č. 5, s. 185-188.
Category: Review

Overview

Early postoperative anastomotic complications have serious clinical implications for the patient’s morbidity, mortality as well as long-term results. A number of measures can be undertaken to reduce the risk of anastomotic complications, including intraoperative colorectal anastomotic integrity assessment. Methods used to assess anastomotic reliability have gradually developed from basic mechanical techniques, direct visual endoluminal inspection, to microperfusion assessment of perianastomotic tissue. Moderate benefit in terms of reduced postoperative anastomotic complications has been shown with mechanical patency testing and partly with intraoperative endoscopic visualization of colorectal anastomoses. More recently, indocyanine green (ICG) fluorescence imaging methods have emerged as major contributions to anastomotic patency assessment and intraoperative decision making during surgical colorectal procedures including decreased numbers of ileostomies.

Key words:
colorectal surgery – complications – near infrared fluoroscopy (NIR) – indocyanine green (ICG)


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Surgery Orthopaedics Trauma surgery
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