{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:33:03Z","timestamp":1791595983812,"version":"4.3.4"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Anastomotic leakage (AL) is a dreaded complication following colorectal cancer surgery, impacting patient outcome and leads to increasing healthcare consumption as well as economic burden. Bowel perfusion is a significant modifiable factor for anastomotic healing and thus crucial for reducing AL.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aims<\/jats:title>\n                <jats:p>The study aimed to calculate a cut-off value for quantified laser speckle perfusion units (LSPUs) in order to differentiate between ischemic and well-perfused tissue and to assess inter-observer reliability.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>LSCI was performed using a porcine ischemic small bowel loop model with the PerfusiX-Imaging\u00ae system. An ischemic area, a well-perfused area, and watershed areas, were selected based on the LSCI colormap. Subsequently, local capillary lactate (LCL) levels were measured. A logarithmic curve estimation tested the correlation between LSPU and LCL levels. A cut-off value for LSPU and lactate was calculated, based on anatomically ischemic and well-perfused tissue. Inter-observer variability analysis was performed with 10 observers.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Directly after ligation of the mesenteric arteries, differences in LSPU values between ischemic and well-perfused tissue were significant (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and increased significantly throughout all following measurements. LCL levels were significantly different (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) at both 60 and 120\u00a0min. Logarithmic curve estimation showed an R<jats:sup>2<\/jats:sup> value of 0.56 between LSPU and LCL values. A LSPU cut-off value was determined at 69, with a sensitivity of 0.94 and specificity of 0.87. A LCL cut-off value of 3.8\u00a0mmol\/L was found, with a sensitivity and specificity of 0.97 and 1.0, respectively. There was no difference in assessment between experienced and unexperienced observers. Cohen\u2019s Kappa values were moderate to good (0.52\u20130.66).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Real-time quantification of LSPUs may be a feasible intraoperative method to assess tissue perfusion and a cut-off value could be determined with high sensitivity and specificity. Inter-observer variability was moderate to good, irrespective of prior experience with the technique.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00464-024-11076-3","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T18:02:36Z","timestamp":1721239356000},"page":"5292-5303","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Real-time quantification of laser speckle contrast imaging during intestinal laparoscopic surgery: successful demonstration in a porcine intestinal ischemia model"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8176-8190","authenticated-orcid":false,"given":"J. Tim","family":"Hoffman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danique J. 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PerfusiX-Imaging\u00ae equipment was provided by LIMIS Development BV, Leeuwarden, The Netherlands. Wido T. Heeman and Tim Hoffman are employed by LIMIS Development BV. Laurents P.S. Stassen is a member of the advisory board of Diagnostic Green GmbH. Nicole D. Bouvy is a member of the advisory board of Activ Surgical and received an education grant from Medtronic. Danique J.I. Heuvelings, Mahdi Al-Taher, E Christiaan Boerma, Schelto Kruijff, and Tim van Zutphen have no conflict of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"The animal study protocol was approved by the Experimental Animal Committee of Maastricht University (DEC-UM; Number: 2017-021-001).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}