Evidence map›Paper›PMID 35199204›Full record

ArticleSurgical endoscopy2022

The use of fluorescence angiography to assess bowel viability in the acute setting: an international, multi-centre case series.

Johanna J Joosten, Grégoire Longchamp, Mohammad F Khan, Wytze Lameris, Mark I van Berge Henegouwen, Wilhelmus A Bemelman, Ronan A Cahill, Roel Hompes, Frédéric Ris

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 3 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 3 countries.

Johanna J JoostenDepartment of Surgery, Amsterdam University Medical Centres (UMC), University of Amsterdam, Cancer Centre Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.ORCID http://orcid.org/0000-0001-6381-8182
Grégoire LongchampDivision of Digestive Surgery, University Hospitals of Geneva, 1205, Geneva, Switzerland.
Mohammad F KhanDepartment of Surgery, Mater Misericordiae University, Hospital, 47 Eccles Street, Dublin 7, Ireland.
Wytze LamerisDepartment of Surgery, Amsterdam University Medical Centres (UMC), University of Amsterdam, Cancer Centre Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
Mark I van Berge HenegouwenDepartment of Surgery, Amsterdam University Medical Centres (UMC), University of Amsterdam, Cancer Centre Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
Wilhelmus A BemelmanDepartment of Surgery, Amsterdam University Medical Centres (UMC), University of Amsterdam, Cancer Centre Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
Ronan A CahillDepartment of Surgery, Mater Misericordiae University, Hospital, 47 Eccles Street, Dublin 7, Ireland.
Roel HompesDepartment of Surgery, Amsterdam University Medical Centres (UMC), University of Amsterdam, Cancer Centre Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands. r.hompes@amsterdamumc.nl.
Frédéric RisDivision of Digestive Surgery, University Hospitals of Geneva, 1205, Geneva, Switzerland.
University of Amsterdam · NLUniversity Hospital of Geneva · CHAmsterdam University Medical Centers · NLMater Misericordiae University Hospital · IEUniversity College Dublin · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAssessing bowel viability can be challenging during acute surgical procedures, especially regarding mesenteric ischaemia. Intraoperative fluorescence angiography (FA) may be a valuable tool for the surgeon to determine whether bowel resection is necessary and to define the most appropriate resection margins. The aim of this study is to report on FA use in the acute setting and to judge its impact on intraoperative decision making. MATERIALS AND

methodsThis is a multi-centre, retrospective case series of patients undergoing emergency abdominal surgery between February 2016 and 2021 in three general/colorectal units where intraoperative FA was performed to assess bowel viability. Primary endpoint was change of management after the FA assessment.

resultsA total of 93 patients (50 males, 66.6 ± 19.2 years, ASA score ≥ III in 85%) were identified and studied. Initial surgical approach was laparotomy in 66 (71%) patients and laparoscopy in 27 (29% and seven, 26% conversions). The most common aetiologies were mesenteric ischaemia (n = 42, 45%) and adhesional/herniae-related strangulation (n = 41, 44%). In 50 patients a bowel resection was performed. Overall rates of anastomosis after resection, reoperation and 30-day mortality were 48% (n = 24/50, one leak), 12% and 18%, respectively. FA changed management in 27 (29%) patients. In four patients (4% overall), resection was avoided and in 21 (23%) extra bowel length was preserved (median 50 cm of bowel saved, IQR 28-98) although three patients developed further ischaemia. FA prompted extended resection (median of 20 cm, IQR 10-50 extra bowel) in six (6%) patients.

conclusionIntraoperative use of FA impacts surgical decisions regarding bowel resection for intestinal ischaemia, potentially enabling bowel preservation in approximately one out of four patients. Prospective studies are needed to optimize the best use of this technology for this indication and to determine standards for the interpretation of FA images and the potential subsequent need for second-look surgeries.

Indexed as

Indocyanine GreenMesenteric IschemiaAnastomosis, SurgicalFluorescein AngiographyHumansIschemiaMaleRetrospective StudiesIndocyanine GreenAcute settingCase seriesChange of managementFluorescence angiographyIschaemia

Identifiers

PMID35199204
PMCPMC9485089
OpenAlexW4214713301

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.