Evaluation of blood flow on the remnant distal bowel during left-sided colectomy

• Published in: World journal of surgical oncology Vol. 16; no. 1; pp. 188 - 4
• Main Authors: Ogino, Takayuki, Okuyama, Masaki, Hata, Tomoki, Kawada, Junji, Okano, Miho, Kim, Yongkook, Tsujinaka, Toshimasa
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 13.09.2018; BioMed Central; BMC
• Subjects: Aged; Anastomosis; Anastomosis, Surgical - adverse effects; Anastomotic Leak - etiology; Anastomotic Leak - prevention & control; Anastomotic leakage; Arteries; Blood flow; Colectomy; Colectomy - adverse effects; Colectomy - methods; Colon; Colon - blood supply; Colon - diagnostic imaging; Colon - surgery; Colorectal cancer; Colorectal surgery; Correspondence; Evaluation; Family medical history; Female; Fluorescence; Fluorescent Dyes; Health aspects; Hospitals; Humans; Indocyanine Green; Intestine; Laparoscopy; Left-sided colectomy; Lymphatic system; Postoperative complications; Prevention; Prognosis; Rectum; Rectum - blood supply; Rectum - diagnostic imaging; Rectum - surgery; Risk factors; Spectrophotometry, Infrared - instrumentation; Spectrophotometry, Infrared - methods; Surgery; Systematic review; Veins & arteries; Viability; Japan; Indocyanine green; Anastomotic leakage; Left-sided colectomy
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-018-1487-2

Adequate blood flow in anastomosis is of paramount importance to prevent anastomotic leakage. However, it is sometimes difficult to predict the viability of the intestine during surgery. During left-sided colectomy, blood flow on the remnant distal bowel is supplied only from the middle and inferior rectal arteries. The blood backflow after the root ligation of the inferior mesenteric artery is often said to be kept up to promontorium levels; however, this premise is actually based on experience, without reliable evidence. Here, we introduce the intraoperative evaluation of blood flow on the remnant distal bowel during left-sided colectomy using an indocyanine green fluorescence technique.