Оценка перфузии кишечной стенки в условиях ишемии с применением метода гиперспектральной визуализации

Abstract

(Russian language article: translated abstract):  Background. Acute intestinal ischemia is a disease characterized by a violation of blood supply, which leads to hypoxia of intestinal wall tissues and secondary pathological changes. One of the main factors determining the urgency of the problem of acute intestinal ischemia is the intraoperative determination of the viability of the intestinal wall, which plays a leading role in determining the volume of surgery and in the prognosis of the postoperative period. Objective. Improving the results of diagnosing disorders of the blood supply to the tissues of the intestinal wall in small model an-imals based on the use of the hyperspectral imaging method. Material and methods. The experimental study was conducted in 9 clinically healthy, sexually mature Wistar laboratory rats. The assessment of intestinal viability and the development of secondary pathologic changes was performed using the Kerte’s vi-sual method. Intestinal wall perfusion was determined using a hyperspectral imaging system. The object of the study was a model of intestinal ischemia with violation of mesenteric blood flow with the formation of a ligature blocking the feeding vessel during laparotomy under inhalation anesthesia. Relaparotomy was performed after 1, 6 and 12 hours, during which the intestine was re-moved from the abdominal cavity and an intraoperative assessment of intestinal tissues viability was performed. Intestinal resection with sampling of fragments for morphologic examination was performed in accordance with the time intervals of ligature application of the study protocol. Results. The studies resulted in obtaining two-dimensional color maps of intestinal tissue saturation at different stages of ischemia modeling (1, 6 and 12 hours). The mean saturation value for the intact intestinal wall was 66±2%, after 1 hour from the time of isch-emia modeling it was 42±5%, after 6 hours — 26±3%, after 12 hours the mean saturation value was 21±3%. Conclusion. Application of hyperspectral imaging allows noninvasive and objective intraoperative assessment of the nature of isch-emic damage of the intestinal wall without additional use of exogenous fluorescent substances. This may improve the quality of surgical procedures for ischemic intestinal lesions.