BACKGROUND AND STUDY AIMS Anastomotic ischemia can affect healing and eventually lead to anastomotic leakage, and confocal laser endomicroscopy (CLE) can offer detailed observations at the subcellular level. We aimed to evaluate the anastomotic microcirculation in different anastomotic perfusion models using CLE. METHODS Anastomotic perfusion models were established using twelve rabbits distributed into two groups: group A (good perfusion, n = 6) and group B (poor perfusion, n = 6). Afterward, intraoperative detection of anastomotic perfusion was carried out using CLE, and quantitative analysis of blood cells was performed. Rabbits that satisfied the criteria underwent a second exploratory operation and specimens were stained by hematoxylin and eosin. RESULTS Enhanced with fluorescein sodium, capillaries were obviously highlighted in group A, while few capillaries were viewed in group B. Delayed development of fluorescence occurred in group B. The average flow of blood cells was 37.0 ± 5.93 per minute in group A and 6.33 ± 2.16 per minute in group B (p < 0.001). In addition, during the second exploratory surgery, rabbits with inadequate anastomotic perfusion exhibited more serious intestinal adhesion and ischemia. Anastomotic leakage and abdominal infection occurred in all rabbits in group B. CONCLUSION CLE can realize real-time imaging of the anastomotic microcirculation and is a feasible technique for performing intraoperative evaluation in different anastomotic perfusion situations. This animal experiment provides the groundwork for future in vivo research in humans.

中文翻译：

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在吻合模型中使用共聚焦激光显微内窥镜在结直肠手术中实时评估吻合口血液供应。

背景和研究目的 吻合口缺血会影响愈合并最终导致吻合口漏，而共聚焦激光显微内窥镜 (CLE) 可以提供亚细胞水平的详细观察。我们旨在使用 CLE 评估不同吻合灌注模型中的吻合微循环。方法 12只兔建立吻合口灌注模型，分为两组：A组（灌注良好，n = 6）和B组（灌注不良，n = 6）。之后，使用CLE进行术中吻合口灌注检测，并进行血细胞定量分析。满足标准的兔子进行第二次探查手术，标本用苏木精和伊红染色。结果荧光素钠增强，A组毛细血管明显突出，而在 B 组中观察到很少的毛细血管。B 组出现荧光延迟发展。A 组的平均血细胞流量为每分钟 37.0 ± 5.93 个，B 组为每分钟 6.33 ± 2.16 个（p < 0.001）。此外，在第二次探查手术中，吻合口灌注不足的兔表现出更严重的肠粘连和缺血。B组家兔均发生吻合口漏和腹腔感染。该动物实验为未来的人体体内研究奠定了基础。A 组的平均血细胞流量为每分钟 37.0 ± 5.93 个，B 组为每分钟 6.33 ± 2.16 个（p < 0.001）。此外，在第二次探查手术中，吻合口灌注不足的兔表现出更严重的肠粘连和缺血。B组家兔均发生吻合口漏和腹腔感染。该动物实验为未来的人体体内研究奠定了基础。A 组的平均血细胞流量为每分钟 37.0 ± 5.93 个，B 组为每分钟 6.33 ± 2.16 个（p < 0.001）。此外，在第二次探查手术中，吻合口灌注不足的兔表现出更严重的肠粘连和缺血。B组家兔均发生吻合口漏和腹腔感染。该动物实验为未来的人体体内研究奠定了基础。吻合口灌注不足的兔表现出更严重的肠粘连和缺血。B组家兔均发生吻合口漏和腹腔感染。该动物实验为未来的人体体内研究奠定了基础。吻合口灌注不足的兔表现出更严重的肠粘连和缺血。B组家兔均发生吻合口漏和腹腔感染。该动物实验为未来的人体体内研究奠定了基础。