Intraoperative laser fluorescence angiography in colorectal surgery: a noninvasive analysis to reduce the rate of anastomotic leakage

Abstract

There was an overall reduction in the absolute revision rate of 4% in the LFA group and a significantly reduced rate of revision in the subgroup analysis of patients undergoing elective colorectal resections, in patients older than 70 years and in patients with hand-sewn anastomosis. This demonstrates that LFA is a method that may significantly reduce not only the rate of severe complications in colorectal surgery but also the hospital length of stay.

Evaluation of intestinal perfusion by ICG fluorescence imaging in laparoscopic colorectal surgery with DST anastomosis

“…The two basic considerations for the success of intestinal anastomosis are mechanical integrity and tissue vascularity. Therefore, surgical technique and adequate perfusion of the anastomosis are essential for the prevention of AL [18,29]. We previously reported that a sufficient amount of precompression time before stapler firings resulted in reduced intestinal wall thickness and proper staple formation in animal models [11][12][13].…”

“…Tests using Doppler technology, tissue oxygen tension and oxygen spectroscopy are still experimental and cannot be used for regular clinical applications because of the complex maneuvers, expensive equipment and lack of reproducibility. In recent years, near-infrared (NIR) fluorescence technology with indocyanine green (ICG) has become the most promising method that allows for an accurate evaluation of intestinal perfusion intraoperatively, thus leading to fewer ALs [18][19][20][21].…”

Intraoperative fluorescence angiography in objectification of relegated colon perfusion in oncocoloproctology: first Russian experience and review of the literature

“…Частота возник-новения несостоятельности первичного анастомоза варьирует в различных исследованиях и может дости-гать 20 % [5][6][7]. По современным данным, регист-рируется снижение частоты несостоятельностей до 1-4 % на фоне выполненной интраоперационной флуоресцентной визуализации адекватности крово-снабжения анастомозируемых участков кишки [34,36].…”

Colorecral Anastomosis Failure (Literature Review)

“…Jafari et al предложили использовать ин-фракрасную лапароскопию с индоцином зеленым [31]. Данные о применении этого метода можно встретить и в работах других авторов [24,34]. При-меняя лазерную флюоресцентную ангиографию, S. Kudszus et al [34] статистически достоверно снизили НШКРА с 7,5 до 3,5 %.…”