Indocyanine green fluorescence imaging to assess bowel perfusion during totally laparoscopic surgery for colon cancer

Su, Hao; Wu, Hui; Bao, Mandula; Luo, Shou; Wang, Xuewei; Zhao, Chenyang; Liu, Qian; Wang, Xishan; Zhou, Zhixiang; Zhou, Haitao

doi:10.1186/s12893-020-00745-4

Cited by 29 publications

(15 citation statements)

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“…A total of 1936 references were finally confirmed by the electronic search, and 73 potentially relevant studies were selected after screening the titles and abstracts. Among the 73 potentially relevant studies, a total of 32 met the inclusion criteria [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. Table 1 and Table S1 summarize the study characteristics.…”

Section: Resultsmentioning

confidence: 99%

“…The readmission rate in a 30-day follow-up was 4.6% vs. 7.2%, respectively, in the ICG vs. the non-ICG group (RR = 0.91; 95% CI: 0.48–1.70; I 2 = 14%; p = 0.76) [ 23 , 37 , 43 ]. However, the readmission rate in a 60-day follow-up equaled 15.5% vs. 10.6% (RR = 0.85; 95% CI: 0.16–4.42; I 2 = 61%; p = 0.85) [ 28 , 33 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…The following supporting information can be downloaded at: . Table S1: Methodology characteristics of the included trials [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]; Table S2: Pooled analysis in subgroups of randomized and non-randomized trials; Table S3: PRISMA checklist. Figure S1: A summary table of the review authors’ judgements for each risk of bias item for each randomized study; Figure S2: A plot of the distribution of the review authors’ judgements for each risk of bias item across randomized studies; Figure S3: A summary table of the review authors’ judgements for each risk of bias item for each non-randomized study; Figure S4: A plot of the distribution of the review authors’ judgements for each risk of bias item across non-randomized studies.…”

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confidence: 99%

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Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients

Safiejko

Tarkowski²,

Kozłowski

et al. 2022

Cancers

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Despite the technological advances and improved surgical skills, the incidence of anastomotic leakage following colorectal cancer surgery still ranges from 4% to 19%. Therefore, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of indocyanine green (ICG) use in colorectal cancer surgery. An online search of the Embase, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases (from inception to 10 November 2021) was performed, in addition to manual screening. Thirty-two studies involving 11,047 patients were considered eligible for the meta-analysis. The anastomotic leak rate in the ICG and non-ICG groups varied and amounted to 3.7% vs. 7.6%, respectively (RR = 0.46; 95% CI: 0.39–0.56; p < 0.001). The rate in randomized controlled trials (RCTs) was 8.1% in the ICG group compared with 12.1% in the non-ICG group (RR = 0.67; 95% CI: 0.46–0.98; p = 0.04). In non-RCTs, it equaled 3.1% vs. 7.3%, respectively (RR = 0.43; 95% CI: 0.35–0.52; p < 0.001). Although the publications encompassed in our meta-analysis present different patients, with different factors influencing the results, a pooled analysis revealed a lower incidence of anastomotic leak in cases with ICG use. There are several other convincing advantages: safety, simplicity, and short time of the method adjustment. The presented meta-analysis indicates ICG perfusion assessment as a tool worth considering to decrease the rate of complications following colorectal surgery—valuable in the context of other, well-known risk factors.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients

Safiejko

Tarkowski²,

Kozłowski

et al. 2022

Cancers

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“…ICG is a safe dye, and its adverse reactions are rarely reported ( 50 , 51 ). In a study of 1,226 participants, adverse events were observed in only eight subjects after intravenous ICG administration of 1 to 5 mg/kg, with only one severe adverse event and no deaths reported ( 52 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of Indocyanine Green Fluorescence Angiography on Anastomotic Leakage in Patients Undergoing Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials and Propensity-Score-Matched Studies

Tang

Tao

et al. 2022

Front. Surg.

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BackgroundMeta-analyses have demonstrated that indocyanine green (ICG) can effectively prevent anastomotic leakage (AL) after colorectal surgery. However, recent evidence from large randomized controlled trial (RCT) has suggested that ICG fluorescence angiography does not reduce the incidence of AL in colorectal surgery. This study was conducted to evaluate the value of ICG for the prevention of AL following colorectal surgery.MethodsUp to September 16, 2021, PubMed, Embase, China National Knowledge Infrastructure, Web of Science, Scopus, Cochrane Library, and VIP databases were searched for RCTs and propensity-score matched (PSM) studies evaluating the use of ICG for prevention of AL after colorectal surgery. Mean differences (MDs) or odds ratios (ORs) and 95% confidence intervals (CI) were calculated.ResultsTwenty studies (5 RCTs and 15 PSM studies) with a total of 5,125 patients were included. ICG did not reduce the reoperation rate (OR, 0.71; 95% CI, 0.38, 1.30), conversion rates (OR, 1.34; 95% CI, 0.65, 2.78), or mortality (OR, 0.50; 95% CI, 0.13, 1.85), but ICG did reduce the incidence of AL (OR, 0.46; 95% CI, 0.36, 0.59) and symptomatic AL (OR, 0.48; 95% CI, 0.33, 0.71), and reduced the length of hospital stay (MD,−1.21; 95% CI,−2.06,−0.35) and intraoperative blood loss (MD,−9.13; 95% CI,−17.52,−0.74). In addition, ICG use did not increase the incidence of total postoperative complications (OR, 0.93; 95% CI, 0.64, 1.35), postoperative ileus (OR, 1.26; 95% CI, 0.53, 2.97), wound infection (OR, 0.76; 95% CI, 0.44, 1.32), urinary tract infection (OR, 0.87; 95% CI, 0.30, 2.59), pulmonary infection (OR, 0.23; 95% CI, 0.04, 1.45), urinary retention (OR, 1.08; 95% CI, 0.23, 5.04), anastomotic bleeding (OR, 1.53; 95% CI, 0.27, 8.60), anastomotic stricture (OR, 0.74; 95% CI, 0.24, 2.29), or operative time (MD,−9.64; 95% CI,−20.28, 1.01).ConclusionsICG can effectively reduce the incidence of AL, without prolonging the operation time or increasing postoperative complications in colorectal surgery.Systematic Review Registrationwww.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42021279064.

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“…Among the methods that allow intraoperative visualization of microcirculation, the most common one is fluorescence imaging with the indocyanine green as a fluorophore [12][13][14]. Tissue perfusion can be assessed using laser Doppler flowmetry [15,16], laser speckle contrast imaging (LSCI) [17,18], sidestream dark field (SDF) microscopy [19,20], incident dark field (IDF) microscopy [21], and hyperspectral imaging (HSI) [22].…”

Section: Introductionmentioning

confidence: 99%

Effect of Surgical Technique on the Microstructure and Microcirculation of the Small Intestine Stump during Delayed Anastomosis: Multimodal OCT Data

Kiseleva¹,

Ryabkov

Sizov

et al. 2021

Sovrem Tehnol Med

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The aim of the study was to use multimodal optical coherence tomography (MM OCT) to evaluate microstructure and microcirculation in the proximal and distal sections of the intestine relative to the resected area in acute mesenteric ischemia.Materials and Methods. The study was carried out using three groups of male Wistar rats weighing 270-435 g (n=18). Acute occlusive arterial ischemia of the small intestine was initiated in all animals. After 80-90 min, the ischemic non-viable part of the intestine was resected, and the operation was completed by stoma exteriorization (group 1, n=6), by applying purse-string sutures (group 2, obstructive resection, n=6), or by internal drainage of the proximal and distal ends of the small intestine (group 3, bypass, n=6). Relaparotomy and anastomosis formation were performed 2 days later.With the help of MM OCT at each stage of the surgical intervention, images were obtained from the serous membrane side: the intestinal wall microstructure (layers) was viewed using cross-polarization OCT (CP OCT) and the intramural circulation -using optical coherent angiography (OCA). The MM OCT images obtained from the terminal intestine sections immediately after resection and 2 days later (before the anastomosis formation) were compared between the experimental groups, as well as with the pre-ischemic data (norm). All resected sections of the intestine were then histologically examined. The MM OCT data were compared with the histological and intravital macroscopy data.Results. As a result of studying the intestinal wall microstructure by in vivo CP OCT, it was found that during ostomy (group 1) and obstructive resection (group 2), the images showed signs of tissue edema and destructive changes in the mucous membrane that were confirmed histologically, while with bypass surgery (group 3), there were minimal changes as compared with the norm.According to the OCA data, on day 2 of ostomy in the proximal and distal segments of the intestine, there was a noticeable disappearance of small and medium blood vessels; mainly large arteries and veins could be visualized. Following obstructive resection (purse-string suturing) or bypass surgery, the most noticeable changes (a decrease in the number of visualized blood vessels) were observed in the distal part of the intestine. The L index calculated from OCA images and characterizing the total length of the intramural perfused vasculature, showed a statistically significant decrease during ostomy: 12.18 [10.40; 14.20] µm -in the proximal and 10.67 [7.98; 13.05] µm -in the distal section; for comparison, the L index before ischemia was 18. 90 [17.98; 19.73] μm and 18.74 [17.46; 19.90] μm, respectively (p=0.0001). In obstructive resection (group 2), statistically significant differences in the L parameter were found only for the distal bowel section: 16.39 [12.37; 18.10] µm compared with 18.74 [17.46; 19.90] μm before ischemia (p=0.041). After bypass surgery (group 3), there were no significant deviations in the L index.Conclusion. By using MM OCT, we ...

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Indocyanine green fluorescence imaging to assess bowel perfusion during totally laparoscopic surgery for colon cancer

Cited by 29 publications

References 29 publications

Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients

Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients

Effect of Indocyanine Green Fluorescence Angiography on Anastomotic Leakage in Patients Undergoing Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials and Propensity-Score-Matched Studies

Effect of Surgical Technique on the Microstructure and Microcirculation of the Small Intestine Stump during Delayed Anastomosis: Multimodal OCT Data

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