EN
TÜRKÇE
Poster - 98
The application of indocyanine green-guided Deloyers procedure in reoperation after subtotal colectomy: a single-center retrospective cohort study
Weike Liu 1, Ruijie Zhou 2, Zheng Zhang 2, Bo Li 3, Qian Jiang 4, Long Li 2, Qi Li 2
1 Department of General Surgery, Capital Institute of Pediatrics, Beijing, China
2 Department of General Surgery, Capital Center for Children's Health, Capital Medical University, Beijing, China
3 Translational Medicine, Hospital for Sick Children, Toronto, Ontario, Canada
4 Department of Medical Genetics, Capital Institute of Pediatrics, Beijing, China
PURPOSE: Subtotal colectomy with ascending colon inversion (Deloyers procedure) is widely used in the definitive surgery of Hirschsprung’s disease(HD) when the abnormal parts involve transverse or even descending colon. However, as short as 10-15 cm colon remained after the operation brings great difficulty to the reoperation for various postoperative complications, facing the risk of total colectomy. Previous researches have proved that indocyanine green (ICG) fluorescence imaging is useful in assessing anastomotic perfusion. This study aims to review our surgical experience and outcome of ICG-guided Deloyers procedure during reoperation after subtotal colectom.
METHODS: A retrospective study was conducted on HD patient who underwent reoperation after subtotal colectom in our center from 2016 to 2024. Whether to had reserved the colon, surgical complications and bowel functional outcomes were compared between the with-ICG-guided group(n=11) and the without-ICG-guided group(n=9).
RESULTS: 20 Patients were included with median age 17.2(0.1–132) months at primary subtotal colectom and 63.2 (7–192) months at reoperation. Compared with patients without ICG-guided Deloyers procedure, those with the ICG-guided had higher incidence of colon reservation (100% vs 44.4%, p=0.008) but similar incidence of surgical complications. In terms of bowel functional outcomes，incidence of perianal infection was lower in ICG-guided group (0% vs 55.6%, p=0.029) , while the differences were not significant in enterocolitis (22.2% vs 77.8%, p=0.057) and soiling (66.7% vs 66.7%, p=1).
CONCLUSION: For children who have undergone subtotal colectomy and developed complications, ICG-guided Deloyers procedure in reoperation is safe and effective. Through such technical improvements, a considerable number of children can retain some length of the colon to improve the quality of their future life.