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Anastomosis Viability Assessment During Esophagectomy

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Video Atlas of Intraoperative Applications of Near Infrared Fluorescence Imaging

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Abstract

Esophagectomy is one of the most complex and morbid procedures in gastrointestinal surgery. Many different technical variations have been described over the years; however, complication rates remain high. Moreover, patients who undergo esophageal surgery are usually affected by severe comorbidities, such as cardiopulmonary, and often are nutritionally deficient secondary to feeding difficulties, history of excessive alcohol consumption, and smoking. Among the complications, the most dreaded is anastomotic leakage, especially if it occurs in the thorax. In fact, the presence of an anastomotic leak significantly increases hospital stay and mortality. Several factors contribute to the development of leaks, in particular hypoalbuminemia, local ischemia, and technical factors. The advent of minimally invasive esophageal techniques has decreased some of the associated comorbidities of such an operation; however, the rate of leakage remains the same and, in certain series, is even higher. Among the several techniques described to reliably assess the blood supply of the anastomosis during esophagectomy, the utilization of fluorescence remains one of the most promising. Hereby, we describe the current technical aspects of fluorescence perfusion assessment during esophagectomy and its results.

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Author information

Authors and Affiliations

  1. Department of General Surgery, The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USA

    Juliana de Paula Machado Henrique, Emanuele Lo Menzo & Raul J. Rosenthal

  2. Hospital de Clinicas Jose de San Martin, Buenos Aires, Argentina

    Fernando Dip

Authors
  1. Juliana de Paula Machado Henrique
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  2. Fernando Dip
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  3. Emanuele Lo Menzo
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  4. Raul J. Rosenthal
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Correspondence to Raul J. Rosenthal .

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Editors and Affiliations

  1. Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic Foundation, Cleveland, OH, USA

    Essa M. Aleassa

  2. Division of General Surgery Division of Surgical Oncology MetroHealth System, Cleveland, OH, USA

    Kevin M. El-Hayek

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Minimally invasive Ivor Lewis esophagectomy with ICG angiography (MP4 420633 kb)

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de Paula Machado Henrique, J., Dip, F., Lo Menzo, E., Rosenthal, R.J. (2020). Anastomosis Viability Assessment During Esophagectomy. In: Aleassa, E., El-Hayek, K. (eds) Video Atlas of Intraoperative Applications of Near Infrared Fluorescence Imaging. Springer, Cham. https://doi.org/10.1007/978-3-030-38092-2_9

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  • DOI: https://doi.org/10.1007/978-3-030-38092-2_9

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  • Online ISBN: 978-3-030-38092-2

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