Special Section on Optical Diagnostic and Biophotonic Methods from Bench to Bedside

Optical fiber probe spectroscopy for laparoscopic monitoring of tissue oxygenation during esophagectomies

[+] Author Affiliations
Daniel S. Gareau, Frederic Truffer

Oregon Health and Science University, Department of Biomedical Engineering, 3303 SW Bond Avenue, Portland, Oregon 97239

Kyle A. Perry, Thai H. Pham, C. Kristian Enestvedt, James P. Dolan, John G. Hunter

Oregon Health and Science University, Department of Surgery, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239

Steven L. Jacques

Oregon Health and Science University, Department of Biomedical Engineering, 3303 SW Bond Avenue, Portland, Oregon 97239

J. Biomed. Opt. 15(6), 061712 (November 19, 2010). doi:10.1117/1.3512149
History: Received February 24, 2010; Revised September 30, 2010; Accepted October 11, 2010; Published November 19, 2010; March 01, 2011
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Anastomotic complication is a major morbidity associated with esophagectomy. Gastric ischemia after conduit creation contributes to anastomotic complications, but a reliable method to assess oxygenation in the gastric conduit is lacking. We hypothesize that fiber optic spectroscopy can reliably assess conduit oxygenation, and that intraoperative gastric ischemia will correlate with the development of anastomotic complications. A simple optical fiber probe spectrometer is designed for nondestructive laparoscopic measurement of blood content and hemoglobin oxygen saturation in the stomach tissue microvasculature during human esophagectomies. In 22 patients, the probe measured the light transport in stomach tissue between two fibers spaced 3-mm apart (500- to 650-nm wavelength range). The stomach tissue site of measurement becomes the site of a gastroesophageal anastamosis following excision of the cancerous esophagus and surgical ligation of two of the three gastric arteries that provide blood perfusion to the anastamosis. Measurements are made at each of five steps throughout the surgery. The resting baseline saturation is 0.51±0.15 and decreases to 0.35±0.20 with ligation. Seven patients develop anastomotic complications, and a decreased saturation at either of the last two steps (completion of conduit and completion of anastamosis) is predictive of complication with a sensitivity of 0.71 when the specificity equaled 0.71.

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© 2010 Society of Photo-Optical Instrumentation Engineers

Citation

Daniel S. Gareau ; Frederic Truffer ; Kyle A. Perry ; Thai H. Pham ; C. Kristian Enestvedt, et al.
"Optical fiber probe spectroscopy for laparoscopic monitoring of tissue oxygenation during esophagectomies", J. Biomed. Opt. 15(6), 061712 (November 19, 2010). ; http://dx.doi.org/10.1117/1.3512149


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