P-274EVALUATION OF THE PERFUSION OF THE GASTRIC SLEEVE AFTER OESOPHAGECTOMY BY LASER-INDUCED FLUORESCENCE OF INDOCYANINE-GREEN BY PINPOINT®
Bibliographic record
Abstract
Objectives: Anastomotic leakage after oesophagectomy is a common, severe complication associated with increased mortality, often caused by poor perfusion. Until recently, surgical experience was the only tool to assess the sufficiency of the blood perfusion of the anastomotic region. Indocyanine-green laser-induced fluorescence has been proposed to evaluate tissue perfusion recently. PinPoint is a newly developed system suitable for evaluation of tissue perfusion during laparoscopic and open procedures. Methods: Laser-induced fluorescence of Indocyanine-green tissue angiography by PinPoint technology (Novadaq, Canada) was used to evaluate the perfusion of gastric sleeve in 12 patients undergoing oesophagectomy with gastric tube reconstruction with intrathoracic/cervical anastomosis. After creating the gastric sleeve, 8 mg of ICG were intravenously administered and flushed with normal saline. The images were retrieved, beginning 5 s after the injection. A newly developed software interface was used to analyse the microperfusion data. Results: After injection of ICG the gastric sleeve showed a rapid homogenous perfusion in the proximal part in all cases. In the area of the tip of the sleeve the area of diminished perfusion determined by the use of PinPoint did not meet in all cases the surgeon's assumed point of the start of malperfusion. In 3 out of 12 cases the sleeve was further shortened after interpretation of PinPoint for anastomosis. The sleeve was shortened to the point of homogeneous ICG perfusion in all cases. The advanced software allowed a more objective evaluation of arterial supply, venous drainage and tissue microperfusion due to signal noise reduction of ICG within the tissue. Conclusions: ICG tissue angiography represents a feasible and reliable technical support in the evaluation of perfusion of the gastric tube after oesophagectomy. The latest software allows a more objective evaluation of the perfusion. However an exact quantitative perfusion analysis with the camera system is not possible as yet. Disclosure: No significant relationships.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".