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Indocyanine Green Near-Infrared Fluoroangiography Is a Useful Tool in Reducing the Risk of Anastomotic Leakage Following Left Colectomy
Purpose: To evaluate whether visualization of the colon perfusion with indocyanine green near-infrared fluoroangiography (ICG-NIFA) reduces the rate of anastomotic leakage (AL) after colorectal anastomosis. Methods: Patients who underwent elective left colectomy, including all procedures involvi...
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| Autoren: | , , , |
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| Format: | Artikel |
| Sprache: | Englisch |
| Veröffentlicht: |
Philipps-Universität Marburg
2022
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| Online Zugang: | PDF-Volltext |
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| Zusammenfassung: | Purpose: To evaluate whether visualization of the colon perfusion with indocyanine green
near-infrared fluoroangiography (ICG-NIFA) reduces the rate of anastomotic leakage (AL)
after colorectal anastomosis.
Methods: Patients who underwent elective left colectomy, including all procedures
involving the sigmoid colon and the rectum with a colorectal or coloanal anastomosis,
were retrospectively analyzed for their demographics, operative details, and the rate of
AL. Univariate and multivariate analyses were used to compare patients with and without
ICG-NIFA-based evaluation.
Results: Overall, our study included 132 colorectal resections [70 sigmoid resections
and 62 total mesorectal excisions (TMEs)], of which 70 (53%) were performed with
and 62 (47%) without ICG-NIFA. Patients’ characteristics were similar between both the
groups. The majority of the procedures [91 (69%)] were performed by certified colorectal
surgeons, while 41 (31%) operations were supervised teaching procedures. In the ICGNIFA
group, bowel perfusion could be visualized by fluorescence (dye) in all 70 cases, and
no adverse effects related to the fluorescent dye were observed. Following ICG-NIFA, the
transection line was changed in 9 (12.9%) cases. Overall, 10 (7.6%) patients developed
AL, 1 (1.4%) in the ICG-NIFA group and 9 (14.5%) in the no-ICG-NIFA group (p = 0.006).
The multivariate analysis revealed ICG-NIFA as an independent factor to reduce AL.
Conclusion: These results suggest that ICG-NIFA might be a valuable tool to reduce
the rate of AL in sigmoid and rectal resections in an educational setting. |
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| Beschreibung: | Gefördert durch den Open-Access-Publikationsfonds der UB Marburg. |
| Umfang: | 9 Seiten |
| DOI: | 10.3389/fsurg.2022.850256 |