Intraoperative fluorescence angiography and risk factors of anastomotic leakage in mini-invasive low rectal resections

Benčurik, Vladimír; Škrovina, M; Martínek, L; Bartoš, J; Machackova, M.; Dosoudil, Michal; Stepanova, Erika; Přibylová, Lenka; Briš, Radim; Vomáčková, Katherine

doi:10.1007/s00464-020-07982-x

Cited by 21 publications

(14 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 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%

mentioning

confidence: 99%

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 angiography protocols have been introduced for the objective assessment of colon perfusion [ 3 , 7 , 17 , 18 , 19 , 20 , 21 ] and are summarized in Table 4 . All studies have described the intravenous dose of ICG and the NIR system.…”

Section: Discussionmentioning

confidence: 99%

Optimization of indocyanine green angiography for colon perfusion during laparoscopic colorectal surgery

et al. 2021

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“…Several comparative retrospective and prospective studies investigated the relationship between the use of ICG and the 30-d AL rate as the primary outcome[ 31 , 33 , 38 - 40 ]. They showed a statistically significant correlation between ICG FA and reduction in the risk of AL associated with the modification of the proximal section line.…”

Section: Assessment Of Vascular Perfusion At the Anastomotic Sitementioning

confidence: 99%

Intraoperative use of indocyanine green fluorescence imaging in rectal cancer surgery: The state of the art

Peltrini¹,

Podda²,

Castiglioni³

et al. 2021

WJG

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Indocyanine green (ICG) fluorescence imaging is widely used in abdominal surgery. The implementation of minimally invasive rectal surgery using new methods like robotics or a transanal approach required improvement of optical systems. In that setting, ICG fluorescence optimizes intraoperative vision of anatomical structures by improving blood and lymphatic flow. The purpose of this review was to summarize all potential applications of this upcoming technology in rectal cancer surgery. Each type of use has been separately addressed and the evidence was investigated. During rectal resection, ICG fluorescence angiography is mainly used to evaluate the perfusion of the colonic stump in order to reduce the risk of anastomotic leaks. In addition, ICG fluorescence imaging allows easy visualization of organs such as the ureter or urethra to protect them from injury. This intraoperative technology is a valuable tool for conducting lymph node dissection along the iliac lymphatic chain or to better identifying the rectal dissection planes when a transanal approach is performed. This is an overview of the applications of ICG fluorescence imaging in current surgical practice and a synthesis of the results obtained from the literature. Although further studies are need to investigate the real clinical benefits, these findings may enhance use of ICG fluorescence in current clinical practice and stimulate future research on new applications.

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Intraoperative fluorescence angiography and risk factors of anastomotic leakage in mini-invasive low rectal resections

Cited by 21 publications

References 50 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

Optimization of indocyanine green angiography for colon perfusion during laparoscopic colorectal surgery

Intraoperative use of indocyanine green fluorescence imaging in rectal cancer surgery: The state of the art

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