Assessing intraluminal perfusion in colorectal anastomosis

• Research type

  Research Study

• Full title

  Feasibility of intraluminal imaging of blood perfusion for the evaluation of colorectal anastomosis in rectal cancer

• IRAS ID

  165636

• Contact name

  Danilo Miskovic

• Contact email

  d.miskovic@leeds.ac.uk

• Duration of Study in the UK

  1 years, 0 months, 1 days

• Research summary

  Decision making during surgery is a key element affecting outcomes. This is especially true in cases of bowel surgery where the remaining ends of the bowel are joined together after the disease segment is removed.This decision making process is very much dependent on the appearance / state of remaining two bowels ends needing joining up; which in itself means that the bowel ends have good blood supply, hence likely to survive thus rendering the bowel join functional. Up until now, there is no reliable, predictable and measurable method to do such an assessment during surgery.

  We are proposing to investigate the blood flow in the bowel using two methods :

  - ultrasound detectable microbubble technology
  - Indo-cyanine green {ICG} dye test

  Both tests will be used during surgery at two defined points ( before and after segmental bowel removal) during the procedure.One test (microbubble) will followed by the other(dye) at each point of testing.

  Before removing any bowel segment, microbubbles (followed by dye test) will be injected in the patient veins via a cannula and an ultrasound probe ( in the case of the dye test,this will be substituted by a camera) placed through the rectum will be used to capture the signal emitted from the bubbles in the bowel wall at the site where the cut will be made to remove that piece of bowel.After the join is formed, microbubbles(followed by dye test) will be re-injected to test the join.

  The result from both the microbubble and dye test will be compared and weighted against the operating surgeons perception of a leak ( via a graded score). Other patient specific data such as age,blood transfusion requirement etc will be recorded as well as the impact of the interventions on surgical time and clinical effectiveness .

• REC name

  Yorkshire & The Humber - Bradford Leeds Research Ethics Committee

• REC reference

  14/YH/1305

• Date of REC Opinion

  22 Jan 2015

• REC opinion

  Further Information Favourable Opinion