CC BY
7B-O-14
BIOMEDICAL PHOTONICS
ALT'22
Vacuum atraumatic tissue fixation enables multimodal OCT monitoring of
the enterostomy condition
E. Kiseleva1, M. Ryabkov1, М. Sizov1, P. Peretyagin1, E. Bederina1, P. Shilyagin2, N. Gladkova1
FSBEI HE PRMUMOH Russia, 603005, Nizhny Novgorod, Minin and Pozharsky Square 10/1 2FRC Institute of Applied Physics RAS, 46 Ul'yanova St., Nizhny Novgorod, 603950, Russia
kiseleva84@gmail.com
Enterostomy is a common component of surgical treatments for various gastrointestinal conditions, including acute mesenteric ischemia, Crohn's disease or ulcerative colitis and bowel cancer [1, 2]. An enterostomy is a surgical formation of an opening into the intestine through the abdominal wall and the opening is known as a stoma. The ideal time to close the stoma is about 3 to 12 months after surgery, but there are no well-defined criteria for evaluating it to decide whether it is ready for reconstructive surgery or not [3, 4].
The aim was to in vivo assess the microcirculation and microstructure of the enterostomy for different periods after its formation using the multimodal optical coherence tomography (MM OCT) method.
Materials and methods. 10 patients with enterostomies formed in 3-20 days after surgery were enrolled in the study. A highspeed spectral-domain multimodal optical coherence tomograph (IAP RAS, Russia) operating at a wavelength of 1310 nm with a spectral width of 100 ^m and a power of 2 mW was used [5]. It allows for real-time observation of tissue microstructure (cross-polarization mode — CP OCT) (fig. 1 e-j) and microcirculation (angiography mode — OCTA) (fig. 1 b-d). A special vacuum cap to be out on the OCT probe (fig. 1a) was used to obtain MM OCT images in a contact mode without motion artifacts.
Fig. 1. An example of blood vessels visualization from the surface of the small bowel stoma of patient Ivg (76 years old) using multimodal OCT on the 5th after surgery. a - photo of the stoma with an OCT probe attached to its surface using a vacuum cap. b-d - OCTA images, e-j - structural images in co- and cross-polarizations. 3 regions of interest were studied: b - side where the mesentery was previously located, c - anterior side, c - antimesenteric side.
Results. The use of a vacuum cap (fig. 1a) creates a temporary immobilization of tissues and blood flow becomes visible (fig. 1 b-d) due to the reduction of most of the motion artifacts. It can be seen that the network of blood vessels as well as tissue structure are different on different sides of the stoma. These can be used to assess the quality of the blood supply and the degree of morphological changes in intestine tissues which can help determine the optimal time for closure surgery.
The study was funded by the Russian Science Foundation #19-75-10096.
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