Dataset Information

Indocyanine green fluorescence detects the blood flow of the bronchial anastomosis for bronchoplasty "case report".

ABSTRACT:

Introduction

Bronchoplasty is widely accepted as a standard technique with a high degree of difficulty in maintaining a surgical margin for non-small-cell lung cancer (NSCLC). The key to the success of the bronchial anastomosis is both tension and the blood flow. However, local tension is inconsistent with blood distribution.

Case presentation

Operative finding of the right upper bronchoplasty after chemoradiotherapyshowed clear green staining of the upper bronchus, and afterwards, a membranous area of the truncus intermedius. The blood supply of the bronchial anastomosis judged to be enough.

Discussion

Indocyanine green imaging (ICG) can help a scheduled operation be performed safely, especially in extreme situations where there is concern about the blood supply during bronchoplasty.

Conclusion

This report describes a first case concerning the blood distribution of the bronchial anastomosis for bronchoplasty after induction therapy under fluorescence navigation.

SUBMITTER: Uramoto H

PROVIDER: S-EPMC7528123 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Indocyanine green fluorescence detects the blood flow of the bronchial anastomosis for bronchoplasty "case report".

Uramoto Hidetaka H Motono Nozomu N

Annals of medicine and surgery (2012) 20200928

<h4>Introduction</h4>Bronchoplasty is widely accepted as a standard technique with a high degree of difficulty in maintaining a surgical margin for non-small-cell lung cancer (NSCLC). The key to the success of the bronchial anastomosis is both tension and the blood flow. However, local tension is inconsistent with blood distribution.<h4>Case presentation</h4>Operative finding of the right upper bronchoplasty after chemoradiotherapyshowed clear green staining of the upper bronchus, and afterwards ...[more]

PMID: 33024557

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Project description:BackgroundUterine blood flow is an important factor in uterine viability, but the number of blood vessels required to maintain viability is uncertain. In this study, indocyanine green (ICG) fluorescence imaging was used to examine uterine hemodynamics and vessels associated with uterine blood flow in cynomolgus macaque.MethodsThe uterus of a female cynomolgus macaque was cut from the vaginal canal to mimic a situation during trachelectomy or uterine transplantation surgery in which uterine perfusion is maintained only with uterine and ovarian vessels. Intraoperative uterine hemodynamics was observed using ICG fluorescence imaging under conditions in which various nutrient vessels were selected by clamping of blood vessels. A time-intensity curve was plotted using imaging analysis software to measure the T(max) of uterine perfusion for selected blood vessel patterns. Open surgery was performed with the uterus receiving nutritional support only from uterine vessels on one side. The size of the uterus after surgery was monitored using transabdominal ultrasonography.ResultsThe resulting time-intensity curves displayed the average intensity in the regions of the uterine corpus and uterine cervix, and in the entire uterus. Analyses of the uterine hemodynamics in the cynomolgus macaque showed that uterine vessels were significantly related to uterine perfusion (P=0.008), whereas ovarian vessels did not have a significant relationship (P=0.588). When uterine vessels were clamped, ovarian vessels prolonged the time needed to reach perfusion maximum. Postoperative transabdominal ultrasonography showed that the size of the uterus was not changed 2 months after surgery, with recovery of periodic menstruation. The cynomolgus macaque has got pregnant with favorable fetus well-being.ConclusionUterine vessels may be responsible for uterine blood flow, and even one uterine vessel may be sufficient to maintain uterine viability in cynomolgus macaque. Our results show that ICG fluorescence imaging is useful for evaluation of uterine blood flow since this method allows real-time observation of uterine hemodynamics.

Project description:BackgroundChylothorax is the leakage of chyle into the pleural space and is associated with up to 50% morbidity. Although, the identification of traumatic chylothoraces is well described, non-traumatic chylothoraxes, mostly idiopathic, present therapeutic challenges as they are difficult to localize. We describe an attempt at localizing and treating an idiopathic chylothorax refractory to conservative and minimally invasive techniques. This was done using indocyanine green (ICG) and was a joint case between a thoracic surgeon and an interventional radiologist.Case descriptionA 50-year-old female with a recent history of coronavirus disease (COVID)-19 presented with shortness of breath. She was found to have a right pleural effusion and was admitted to the hospital, where a chest tube was inserted and pleural fluid analysis confirmed the diagnosis of a chylothorax. Conservative management was attempted but with little success. Initial magnetic resonance lymphangiogram (MRL) revealed abnormal enhancing lymphatic masses in the right paraspinal thoracic space as well as lympho-venous junction obstruction with large neck collaterals. She then underwent percutaneous lympho-venous junction angioplasty followed by multiple rounds of glue embolization without clinical improvement. The decision was then made to proceed with a thoracotomy, identification of the site of thoracic duct (TD) leakage, and a mechanical pleurodesis assisted by intraoperative imaging. Ten mg of ICG was injected into the inguinal lymph nodes. Using a camera capable of detection of near-infrared (NIR) light, we were able to visualize the site from which the ICG was extravasating in the chest. Glue was then injected in that area to further help in reducing the leak. After keeping her nil per os (NPO) and requiring one more ligation, a repeat MRL showed a markedly decreased leak into the right pleural space. Two weeks later, she was seen in clinic and reported significant improvement in her symptoms.ConclusionsThis is the case of a 50-year-old female who was found to have a significant right chylothorax. She underwent conservative management, followed by tube thoracostomy, and TD ligation but was refractory to treatment. Fluorescence-guided surgery was pivotal to localize the leakage site and help seal it intraoperatively.

Dataset Information

Indocyanine green fluorescence detects the blood flow of the bronchial anastomosis for bronchoplasty "case report".

Introduction

Case presentation

Discussion

Conclusion

Publications

Indocyanine green fluorescence detects the blood flow of the bronchial anastomosis for bronchoplasty "case report".

Similar Datasets

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