Shaz Foo Kim

Qualitative study of the perfusion of the large intestine segment in the laparoscopic total mesorectal excision

Azimov E.H.

Vol-

979

-Issue-

February 8, 2021

Abstract

Abstract. The main aim of the research is to assess the perfusion of the large intestine segment with the JCG angiography in quality and quantity during the laparoscopic TME. 

Materials and methods. The research work was carried out under the analysis of the results of fluorescence imaging of 28 patients diagnosed with the different levels of rectal adenocarcinoma and exposed to TME in laparoscopic way. The materials of the American hospital of Turkish Republic were used in the research work. The fluorescence density of the large intestine was measured and modeled with perfusion diagram beginning from the 30th second after being injected into the peripheral vein in the amount of 4.0 ml after dissolving of JCG (by being 0.25 mg/kg) in 10 ml physiological solution in the course of the operation. The fluorescence intensity of the large intestine segment was assed as weak, mean and high by using the indexes of fluorescence slope,  T ½ max and time correlation  (TR=1/2 T max/Tmax) over the diagram. The clinical factors were analyzed for study the integrity of anastomosis together. 

Results. 17 of the patients were women, 10 of them were men and the age limit was 62.5. Laparoscopic TME was conducted on all of the patients. Complications associated with anastomosis were noted in 11.7% of the patients. The anastomotic attack in 2 patients, 1 anastomotic narrowness in 1 patient. TR>0.6 that is the quantity indexes of perfusion, tells about the lower perfusion. We consider the use of an intestinal fragment with low perfusion in creating of anastomoses as a great risk in respect of the anastomotic attack, anastomotic narrowness and necrosis of the anastomotic zone.

Conclusion: The use of quantity indexes as ½ T max and TR during the study of perfusion with JCG, assisted in finding the intestinal segment with weak perfusion.

Key words.  JCG angiography, laparoscopic TME, fluorescence imaging , quantity indexes as ½ T max and TR.