Laser speckle contrast imaging for real‐time assessment of colonic perfusion to prevent anastomotic leakage after anterior rectal resection: A single‐centre prospective pilot study

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Main Authors: Jiazi Yu, Wei Cui, Meiling Du, Tao Zhou, Mian Yang, Yupeng Zheng, Hongyi Yi, Jinling Lu, Pengcheng Li, Suzhan Zhang
Format: Artículo Open Access
Published: Wiley 2025
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author Jiazi Yu
Wei Cui
Meiling Du
Tao Zhou
Mian Yang
Yupeng Zheng
Hongyi Yi
Jinling Lu
Pengcheng Li
Suzhan Zhang
author_facet Jiazi Yu
Wei Cui
Meiling Du
Tao Zhou
Mian Yang
Yupeng Zheng
Hongyi Yi
Jinling Lu
Pengcheng Li
Suzhan Zhang
Jiazi Yu
Wei Cui
Meiling Du
Tao Zhou
Mian Yang
Yupeng Zheng
Hongyi Yi
Jinling Lu
Pengcheng Li
Suzhan Zhang
collection Wiley Open Access
contents Laser speckle contrast imaging for real‐time assessment of colonic perfusion to prevent anastomotic leakage after anterior rectal resection: A single‐centre prospective pilot study Jiazi Yu Wei Cui Meiling Du Tao Zhou Mian Yang Yupeng Zheng Hongyi Yi Jinling Lu Pengcheng Li Suzhan Zhang Colorectal Disease Abstract Aim Anastomotic leakage (AL) is a devastating complication following anterior rectal resection. This study aimed to evaluate whether a strategy utilizing real‐time Laser Speckle Contrast Imaging (LSCI) for intraoperative perfusion assessment could reduce the incidence of AL. Methods We conducted a single‐centre study comparing a prospective cohort undergoing LSCI‐guided surgery (LSCI group) with a historical cohort (retrospective group). Propensity score matching (PSM) was used to balance baseline characteristics. The LSCI system was used to objectively assess bowel perfusion and guide the selection of the proximal transection site. The primary outcome was the rate of anastomotic leakage. Results After PSM, 105 patients in the LSCI group were matched with 176 patients in the control group, with all baseline characteristics being comparable. The incidence of AL was significantly lower in the LSCI group compared to the control group (1.9% vs. 8.5%, p  < 0.05). Furthermore, the rate of severe postoperative infective complications requiring major intervention (percutaneous drainage or reoperation) was also significantly reduced in the LSCI group (1.9% vs. 9.6%; p  = 0.02). In the LSCI group, real‐time perfusion assessment led to an intraoperative change of the planned anastomotic site in 6 patients (5.7%), predominantly in low‐to‐middle rectal cancer cases. Conclusion The use of an LSCI‐guided strategy for real‐time intraoperative perfusion assessment may reduce the rates of both AL and severe postoperative infective complications undergoing ARR surgery. This objective, quantitative technology is a valuable tool for optimizing surgical decision‐making and improving patient outcomes. 10.1111/codi.70340 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/codi.70340
format Artículo Open Access
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institution Wiley Open Access
license_str_mv http://onlinelibrary.wiley.com/termsAndConditions#vor
publishDate 2025
publisher Wiley
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spellingShingle Laser speckle contrast imaging for real‐time assessment of colonic perfusion to prevent anastomotic leakage after anterior rectal resection: A single‐centre prospective pilot study
Jiazi Yu
Wei Cui
Meiling Du
Tao Zhou
Mian Yang
Yupeng Zheng
Hongyi Yi
Jinling Lu
Pengcheng Li
Suzhan Zhang
Colorectal Disease
Laser speckle contrast imaging for real‐time assessment of colonic perfusion to prevent anastomotic leakage after anterior rectal resection: A single‐centre prospective pilot study Jiazi Yu Wei Cui Meiling Du Tao Zhou Mian Yang Yupeng Zheng Hongyi Yi Jinling Lu Pengcheng Li Suzhan Zhang Colorectal Disease Abstract Aim Anastomotic leakage (AL) is a devastating complication following anterior rectal resection. This study aimed to evaluate whether a strategy utilizing real‐time Laser Speckle Contrast Imaging (LSCI) for intraoperative perfusion assessment could reduce the incidence of AL. Methods We conducted a single‐centre study comparing a prospective cohort undergoing LSCI‐guided surgery (LSCI group) with a historical cohort (retrospective group). Propensity score matching (PSM) was used to balance baseline characteristics. The LSCI system was used to objectively assess bowel perfusion and guide the selection of the proximal transection site. The primary outcome was the rate of anastomotic leakage. Results After PSM, 105 patients in the LSCI group were matched with 176 patients in the control group, with all baseline characteristics being comparable. The incidence of AL was significantly lower in the LSCI group compared to the control group (1.9% vs. 8.5%, p  < 0.05). Furthermore, the rate of severe postoperative infective complications requiring major intervention (percutaneous drainage or reoperation) was also significantly reduced in the LSCI group (1.9% vs. 9.6%; p  = 0.02). In the LSCI group, real‐time perfusion assessment led to an intraoperative change of the planned anastomotic site in 6 patients (5.7%), predominantly in low‐to‐middle rectal cancer cases. Conclusion The use of an LSCI‐guided strategy for real‐time intraoperative perfusion assessment may reduce the rates of both AL and severe postoperative infective complications undergoing ARR surgery. This objective, quantitative technology is a valuable tool for optimizing surgical decision‐making and improving patient outcomes. 10.1111/codi.70340 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Laser speckle contrast imaging for real‐time assessment of colonic perfusion to prevent anastomotic leakage after anterior rectal resection: A single‐centre prospective pilot study
topic Colorectal Disease
url https://onlinelibrary.wiley.com/doi/10.1111/codi.70340