Clinical efficacy of bowel perfusion assessment during laparoscopic colorectal resection using laser speckle contrast imaging: A matched case–control study

• Published in: Asian journal of endoscopic surgery 2020-07, Vol.13 (3), p.329-335
• Main Authors: Kojima, Shigehiro, Sakamoto, Tsuguo, Matsui, Yutaka, Nambu, Kyojiro, Masamune, Ken
• Format: Article
• Language: English
• Subjects: anastomotic leakage; Colorectal cancer; Colorectal surgery; fluorescence angiography; Laparoscopy; Lasers
• ISSN: 1758-5902; 1758-5910
• DOI: 10.1111/ases.12759

Introduction Disadvantages of bowel perfusion assessment with indocyanine green fluorescence angiography include the need for a fluorophore and the subjective nature of the assessment. This study was performed to evaluate the clinical efficacy of bowel perfusion assessment using laser speckle contrast imaging (LSCI) during laparoscopic colorectal surgery. Methods The study population comprised the first 27 consecutive patients who underwent laparoscopic left‐sided colorectal resection with intraoperative perfusion assessment using LSCI. The operative outcomes of these patients were compared with those of a matched group of patients without perfusion assessment. We analyzed the flux data expressed in laser speckle perfusion units. Results After propensity score matching, we found no significant between‐group differences in the patients' characteristics with the exception of the cancer stage. No patients undergoing LSCI perfusion assessment developed anastomotic leakage, but five (18.5%) patients in the control group did, at a significantly higher rate in male patients (P = .042). There were no significant differences in other operative outcomes. The laser speckle perfusion unit values after ligating marginal vessels were significantly lower than before ligation (P