Quantitative evaluation of colon perfusion after high versus low ligation in rectal surgery by indocyanine green: a pilot study

Han, Sang-Ick; Lee, Chul Seung; Bae, Jung Hoon; Yoon, Mi Ran; Al-Sawat, Abdullah; Lee, Do Sang; Lee, In Kyu; Lee, Yoon Suk

doi:10.1007/s00464-021-08673-x

Cited by 14 publications

(17 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The implementation of an indocyanine green test to assess the vascularization of the colon at the end of the first stage of the DCAA could be a promising prospect to be explored. 35 One of the main limitations of this study is its retrospective nature. Furthermore, the absence of a control group assessing ICAA with diverting stoma limits the analysis of DCAA as an alternative to the reference technique.…”

Section: Discussionmentioning

confidence: 97%

Is Delaying a Coloanal Anastomosis the Ideal Solution for Rectal Surgery

Collard

Tuech

Sabbagh³

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

Objectives: To assess the specific results of delayed coloanal anastomosis (DCAA) in light of its two main indications. Summary Background Data: DCAA can be proposed either immediately after a low anterior resection (primary-DCAA) or after failure of a primary pelvic surgery as a salvage procedure (salvage-DCAA). Methods: All patients who underwent DCAA intervention at 30 GRECCAR-affiliated hospitals between 2010 and 2021 were retrospectively included. Results: 564 patients (male: 63%; median age: 62 years IQR[53-69]) underwent a DCAA: 66% for primary-DCAA and 34% for salvage-DCAA. Overall morbidity, major morbidity and mortality were 57%, 30% and 1.1%, without any significant differences between primary-DCAA and salvage-DCAA (P=0.933;P=0.238 andP=0.410 respectively). Anastomotic leakage was more frequent after salvage-DCAA (23%) than after primary-DCAA (15%), (P=0.016). Fifty-five patients (10%) developed necrosis of intra-abdominal colon. In multivariate analysis, intra-abdominal colon necrosis was significantly associated with male sex (OR=2.67 95%CI[1.22-6.49];P=0.020), BMI>25 (OR=2.78 95%CI[1.37-6.00];P=0.006) and peripheral artery disease (OR=4.68 95%CI[1.12-19.1];P=0.030). The occurrence of this complication was similar between primary-DCAA (11%) and salvage-DCAA (8%), (P=0.289). Preservation of bowel continuity was reached 3 years after DCAA in 74% of the cohort (primary-DCAA:77% vs. salvage-DCAA: 68%,P=0.031). Among patients with a DCAA fashioned without diverting stoma, 75% (301/403) have never required a stoma at the last follow-up. Conclusions: DCAA makes it possible to definitively avoid a stoma in 75% of patients when fashioned initially without stoma and to save bowel continuity in 68% of the patients in the setting of failure of primary pelvic surgery.

show abstract

Section: Discussionmentioning

confidence: 97%

Is Delaying a Coloanal Anastomosis the Ideal Solution for Rectal Surgery

Collard

Tuech

Sabbagh³

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

show abstract

“…The efforts to establish prospective multicentre registries on diverticular disease could pave the way for a new type of evidence on the treatment of diverticular disease [41]. Given the difficulty in carrying out RCTs without suffering the bias of the samples' heterogeneity and without incurring in ethical issues, the availability of follow-up data of patients operated on for diverticular disease will provide precious information for the decisionmaking process.…”

Section: Discussionmentioning

confidence: 99%

The Dilemma of the Level of the Inferior Mesenteric Artery Ligation in the Treatment of Diverticular Disease: A Systematic Review of the Literature

Cirocchi

Mari

Amato

et al. 2022

JCM

View full text Add to dashboard Cite

Background and aim: Although sigmoidectomy is a well-standardized procedure for diverticular disease, there are still unclear areas related to the varying morphology and vascular supply of the sigmoid colon. The level of vascular ligation could affect the functional outcomes of patients operated on for diverticular disease. The aim of this review is to primarily evaluate sexual, urinary and defecatory function outcomes, as well as postoperative results, in patients who underwent surgery for diverticular disease, with or without inferior mesenteric artery (IMA) preservation. Materials and methods: The MEDLINE/PubMed, WOS and Scopus databases were interrogated. Comparative studies including patients who underwent sigmoidectomy for diverticular diseases were considered. Bowel function, genitourinary function, anastomotic leak, operation time, conversion to open surgery, anastomotic bleeding, bowel obstruction were the main items of interest. Results: Twelve studies were included in the review, three randomized and nine comparative studies. Bowel and genitourinary function are not differently affected by the level of vascular ligation. The site of ligation of IMA did not influence the rate of functional complications, anastomotic leak and bleeding. Of note, the preservation of IMA is associated with a higher conversion rate and longer operative time. Conclusions: Despite the heterogeneity of patient groups, and although the findings should be interpreted with caution, functional and clinical outcomes after sigmoidectomy for diverticular disease do not seem to be affected by the level of vascular ligation as long as the IMA is ligated far from its origin.

show abstract

“…In the field of rectal cancer surgery, high ligation (HL) and low ligation (LL) of the IMA (inferior mesenteric artery) continue to be discussed in terms of perfusion and anastomosis leakage. Han [42] investigated this aspect using ICG. Randomization was utilized to allocate individuals with rectosigmoid or rectal cancer to the high-or low-risk (LL) group.…”

Section: Recto-colonic Perfusionmentioning

confidence: 99%

Indocyanine Green(Icg) And Colorectal Surgery: A Literature Review on Qualitative and Quantitative Methods of Usage

Simion¹,

Ionescu²,

Chitoran³

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: This literature review investigates qualitative and quantitative uses of indocyanine green (ICG) in surgical treatment, as this novel technique has become increasingly popular in ORs (operating rooms) worldwide due to its many advantages. Method: An extensive literature review was performed by searching for relevant terms in 5 international databases (www.pubmed.gov, www.sciencedirect.com, www.scopus.com, www.Oxfordjournals.com, www.reaxys.com). The results of this search were summarized into the main advantages of employing ICG in colorectal surgery as follows: a) intraoperative fluorescence angiography capability; b) fluorescence-guided identification of lymph node involvement in colorectal cancer and the sentinel lymph node method; c) positive fluorescence flagging of a liver tumour as small as "only" 200 tumour cells; d) facilitation of fistula diagnosis; and e) tumour tattooing. Moreover, in addition to qualitative intraoperative ICG use, this technique can be combined with quantitative methods and parameters, such as maximum intensity, relative maximum intensity, and different inflow parameters (time-to-peak, slope, and t1/2max). The conclusion of this article is that fluorescence surgery with ICG aided by near-infrared (NIR) light is a relatively recent technology, an advantage of which is improving the specific anatomic and functional information provided, thus allowing more comprehensive and safer tumour removal as well as preservation of important structures.

show abstract

Quantitative evaluation of colon perfusion after high versus low ligation in rectal surgery by indocyanine green: a pilot study

Cited by 14 publications

References 19 publications

Is Delaying a Coloanal Anastomosis the Ideal Solution for Rectal Surgery

Is Delaying a Coloanal Anastomosis the Ideal Solution for Rectal Surgery

The Dilemma of the Level of the Inferior Mesenteric Artery Ligation in the Treatment of Diverticular Disease: A Systematic Review of the Literature

Indocyanine Green(Icg) And Colorectal Surgery: A Literature Review on Qualitative and Quantitative Methods of Usage

Contact Info

Product

Resources

About