Introduction: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a challenging operation. Especially the mobilization of the pouch into the pelvis can be complex. Adequate perfusion of the pouch is required for optimal healing and functioning. Methods: With hyperspectral imaging (HSI) wavelengths between 500 and 1,000 nm can be analyzed in addition to visible light and by reflecting patterns. This intraoperative procedure is non-invasive, contact-free, and no contrast medium is needed. Fifteen patients undergoing IPAA were examined prospectively, and the pouch was evaluated by HSI intraoperatively. HSI was measured in standardized fashion at 4 defined locations of the J-pouch. Each measurement took about 10 s. The clinical postoperative course was assessed in all patients and correlated to the intraoperative HSI findings. Results: Mean near-infrared perfusion and oxygenation of patients showed values ≥74% for all defined pouch areas, revealing good blood supply. Three minor anastomotic leaks were detected by standard pouchoscopy in the postoperative course, which could be treated conservatively with endosponge therapy. Conclusion: HSI values of perfusion and oxygenation of the IPAA were high. The leak rate is associated with redo procedures. This is reflected by the current literature and most likely related to the higher complexity of the revisional pouch operation. HSI has proved itself as a quick and effective new intraoperative tool to evaluate pouch perfusion objectively and quantitatively.
Visc Med

中文翻译：

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高光谱成像：一种新的术中评估接受修复性直肠结肠切除术患者储袋的工具

简介：恢复性结直肠切除术与回肠储袋肛管吻合术 (IPAA) 是一项具有挑战性的手术。尤其是小袋进入骨盆的动员可能很复杂。袋的充分灌注是最佳愈合和功能所必需的。方法：使用高光谱成像 (HSI)，除了可见光和反射图案外，还可以分析 500 到 1,000 nm 之间的波长。这种术中过程是非侵入性的、无接触的，并且不需要造影剂。对 15 名接受 IPAA 的患者进行了前瞻性检查，并在术中通过 HSI 评估了储袋。HSI 在 J 袋的 4 个定义位置以标准化方式测量。每次测量大约需要 10 秒。对所有患者的临床术后过程进行了评估，并与术中 HSI 发现相关联。结果：患者的平均近红外灌注和氧合在所有定义的储袋区域均显示 ≥74% 的值，表明血液供应良好。在术后过程中通过标准袋镜检查发现 3 处轻微的吻合口漏，可以通过内海绵治疗进行保守治疗。结论： IPAA的灌注和氧合HSI值较高。泄漏率与重做程序相关。这反映在当前的文献中，很可能与修正性造口袋操作的复杂性较高有关。HSI 已被证明是一种快速有效的新型术中工具，可以客观和定量地评估储袋灌注。
粘性医学