After esophageal surgery, bacterial pulmonary infection is one of the largest determinants of post-operative complications (40% of the patients). The supervisors proved Selective Decontamination of the Digestive tract (SDD) to be effective in intensive care patients. Further there seems to be a positive effect on anastomotic leakage when using SDD peri-operatively in major gastrointestinal surgery. Yet, SDD has not been applied peri-operatively in the field of esophagectomy and its impact on post-operative recovery and complications such as pneumonia, and anastomotic dehiscence. ESR 1.4 will set up a multicenter randomised clinical trial of SDD in patients undergoing esophagectomy in The Netherlands.
In cooperation with the University of Edinburgh (www.proteus.ac.uk), ESR 1.4 will introduce innovative optical imaging by microendoscopy and targeted optical tracers in patients with the suspicion of pneumonia for the early detection of bacterial and fungal infections. A novel multiwavelength clinical molecular fluorescence endoscopy system for lung imaging is introduced, tested and evaluated in an explanted lung model of discarded donor lungs unsuitable for in-human lung transplantation, in combination with Good Manufacturing Practice (GMP) produced optical tracer for the detection of neutrophils and bacteria in lungs. Subsequently, patients with the suspicion of a pulmonary infection will be imaged by this fiber-based system in combination with a cocktail of both a neutrophil and bacteria specific fluorescent tracer.
ESR 1.4 will actively be involved in the translation and valorisation of these new diagnostic techniques in cooperation with Edinburgh Molecular Imaging (EMI) Ltd.
- Dr. E.A.M. Verschuuren, UMCG
- Prof. Dr. J.M. van Dij, Molecular Bacteriology, MMBI, UMCG
- Dr. M van Oosten, MMBI, UMCG
University of Edinburgh, UK
Edinburgh Molecular Imaging (EMI) Ltd, UK.
SDD, esophagectomy, fluorescence endoscopy, tracer