Background Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Nearinfrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry. Methods Analysis of data prospectively collected by the registry members provided patient and procedural data along with the ICG dose, timing, and consequences of NIRF imaging. Among the included upper-GI, colorectal, and bariatric surgeries, subgroup analysis was performed to identify risk factors associated with complications. Results A total of 1240 patients were included in the study. The included patients, 74.8% of whom were operated on for cancer, originated from 8 European countries and 30 hospitals. A total of 54 surgeons performed the procedures. In 83.8% of cases, a pre-anastomotic ICG dose was administered, and in 60.1% of cases, a post-anastomotic ICG dose was administered. A significant difference (p < 0.001) was found in the ICG dose given in the four pathology groups registered (range: 0.013-0.89 mg/kg) and a significant (p < 0.001) negative correlation was found between the ICG dose and BMI. In 27.3% of the procedures, the choice of the anastomotic level was guided by means of NIRF imaging which means that in these cases NIRF imaging changed the level of anastomosis which was first decided based on visual findings in conventional white light imaging. In 98.7% of the procedures, the use of ICG partly or strongly provided a sense of confidence about the anastomosis. A total of 133 complications occurred, without any statistical significance in the incidence of complications in the anastomoses, whether they were ICG-guided or not. ConclusionThe EURO-FIGS registry provides an insight into the current clinical practice across Europe with respect to NIRF imaging of anastomotic perfusion during digestive tract surgery.

Background: Gastrointestinal stromal tumors (GISTs) represent the majority of primary nonepithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by the immunohistochemical staining for the CD117 antigen. Extra-gastrointestinal stromal tumors (EGISTs) are neoplasms with overlapping immunohistological features, occurring in the abdomen outside the gastrointestinal tract with no connection to the gastric or intestinal wall.

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To the Editor, The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, responsible for coronavirus disease 2019 (COVID-19), has rapidly reached a pandemic spreading.Contagion mainly occurs through the upper respiratory tract that is often involved in early disease, and pulmonary damage is the main cause of death. Nevertheless, SARS-CoV-2 can virtually localize in every organ, engendering site-specific damage. 1 COVID-19 complications due to the prothrombotic potential associated with SARS-CoV-2 infection go beyond deep venous thrombosis and pulmonary thromboembolisms (PTEs). 2 Additional extrapulmonary tissues, such as heart, brain, and splanchnic organs, may be affected by thromboembolic events, likely originating from large vessels or due to microcirculation damage, across a wide LETTER TO THE EDITOR | 1941 gallbladder vasculitis, 7-9 have been described in affecting hepatic circulation. 10