Evaluation of Microcirculation in Colon Wall and Bowel Anastomosis by Laser Induced Fluorescence Video Angiography

NCT ID: NCT01419860

Last Updated: 2022-05-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

4 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-01-31

Study Completion Date

2016-12-31

Brief Summary

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The aim of the study is to describe utility of dynamic fluorescence videoangiography of indocyanine green (ICG) in gastrointestinal surgery, for evaluation of microcirculation in colon wall and anastomosis before and after surgical resection; and if this technique can guide the surgeon to peroperative decision making considering recreate a new anastomosis or stoma for preventing anastomotic failure or stomia necrosis.

Detailed Description

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In our study the investigators prospectively include patients with colon cancer requiring elective surgical operation. All types of colon resection were carried out according to standard procedures. Guidelines for preoperative examination according to NGICG (Norwegian Gastro-Intestinal Cancer Group) to grade the disease, select the most suitable patients and plan further treatment.

Microcirculation of colon wall was assessed by dynamic laser-induced-fluorescence-videoangiography (IC-VIEW, PULSION Medical Systems AG, Munich, Germany) of indocyanine green (ICG). ICG is a water-soluble tricarbocyanine dye that binds strongly to plasma proteins after intravenous injection and is exclusively distributed in intravascular space. Additionally this system houses a laser (energy Pi = 0.16 W, wavelength = 780 nm) that causes excitation/illumination of the fluorescence light from intravascular plasma bound ICG. This light has a spectral range near-infrared energy (NIR) with a maximum at 805 nm and emits fluorescence at 835 nm. It passes through infrared filter on a digital video camera and results in recording of real time fluorescent image from perfusion of plasma bound ICG within small plexus of blood vessels in the bowel wall. Besides that it also demonstrates perfusion from surrounding structures such as appendix epiploic and pericolic fat. The maximum penetration of the laser into tissue is 3-5 mm and general normal thickness of colon wall is 3-5 mm. This method makes it a presentable tracer for tissue perfusion of anterior bowel wall.

Conditions

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Colon Cancer Benign Colon Diseases

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Pixel intensity

Pixel intensity of fluorescence signal describing pixel microcirculation of colon

Group Type EXPERIMENTAL

Elective colon resection

Intervention Type PROCEDURE

In our scientific experiment, we evaluate microcirculation in colon wall and anastomosis with laser induced fluorescence videoangiography of ICG. By implementing this technique we can measure average pixel intensity of fluorescence signal in area of interest on bowel, which represents tissue perfusion in this respective part of intestinal wall.

Interventions

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Elective colon resection

In our scientific experiment, we evaluate microcirculation in colon wall and anastomosis with laser induced fluorescence videoangiography of ICG. By implementing this technique we can measure average pixel intensity of fluorescence signal in area of interest on bowel, which represents tissue perfusion in this respective part of intestinal wall.

Intervention Type PROCEDURE

Other Intervention Names

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Surgical colon operations Right sided hemicolectomy Left sided hemicolectomy Sigmoideum resection Subtotal colon resection

Eligibility Criteria

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Inclusion Criteria

* Patients with colon cancer requiring elective surgical operation.

Exclusion Criteria

* Pregnancy
* Children or patients below the age of 18 years
* Advanced renal or hepatic failure
* Previous allergic reactions to ICG and iodide
* Chronic anemia
* Active haematologic disease
* Women of fertile age needed a negative pregnancy test to be included
* Patients with previous colectomy or anorectal surgery were also excluded due to anatomical insult on mesenterial circulation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ostfold Hospital Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Muiz A. Chaudhry, MD

Role: PRINCIPAL_INVESTIGATOR

Ostfold Hospital Trust HF

Locations

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Østfold Hospital Trust HF

Fredrikstad, Østfold fylke, Norway

Site Status

Countries

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Norway

References

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Related Links

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http://pubmed.gov

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Other Identifiers

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Microcirculation of colon

Identifier Type: -

Identifier Source: org_study_id

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