Equivocal Effect of Intraoperative Fluorescence Angiography on Colorectal Anastomotic Leaks

Kin, Cindy; Vo, Hong; Welton, Lindsay; Welton, Mark L.

doi:10.1097/dcr.0000000000000320

Cited by 107 publications

(89 citation statements)

References 13 publications

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“…In addition, the retrospective casecontrol analysis examining fluorescence imaging in robotic rectal surgery has limitations such as inherent selection bias and small sample size (n = 40) [19]. Recently, a casematched retrospective study including historical control subjects revealed that the intraoperative fluorescence imaging was not associated with a reduction of AL in colorectal surgery [33]. Because of the limited number of patients and the likely multifactorial nature of AL, it is difficult to draw robust conclusions concerning the beneficial effect of fluorescence imaging on the AL rate.…”

Section: Discussionmentioning

confidence: 95%

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

et al. 2016

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Section: Discussionmentioning

confidence: 95%

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

et al. 2016

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“…The assessment of rectal stump perfusion by transanal ICG imaging can be a promising method, although further studies are needed to correlate this technique to the clinical outcome. However, another recent another report stated that the intraoperative fluorescence imaging does not reduce the AL rate in colorectal surgery from a casematched retrospective study with the use of historical control subjects [85] . Because of the limited number of patients and the likely multifactorial nature of AL, it is hard to draw robust conclusions concerning the beneficial effect of fluorescence imaging on the AL rate.…”

Section: Blood Supplymentioning

confidence: 98%

Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis

Kawada

Sakai

2016

WJG

109

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Anastomotic leakage (AL) is one of the most devastating complications after rectal cancer surgery. The double stapling technique has greatly facilitated intestinal reconstruction especially for anastomosis after low anterior resection (LAR). Risk factor analyses for AL after open LAR have been widely reported. However, a few studies have analyzed the risk factors for AL after laparoscopic LAR. Laparoscopic rectal surgery provides an excellent operative field in a narrow pelvic space, and enables total mesorectal excision surgery and preservation of the autonomic nervous system with greater precision. However, rectal transection using a laparoscopic linear stapler is relatively difficult compared with open surgery because of the width and limited performance of the linear stapler. Moreover, laparoscopic LAR exhibits a different postoperative course compared with open LAR, which suggests that the risk factors for AL after laparoscopic LAR may also differ from those after open LAR. In this review, we will discuss the risk factors for AL after laparoscopic LAR.

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“…11 On the contrary, there is a report that ICG fluorescence imaging to assess the blood flow on the anastomosis site had no impact on prediction of AL. 12 If it is possible to evaluate the possibility of AL with high accuracy by intraoperative ICG fluorescence imaging, it will be possible for us to construct DS only in necessary cases.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Indocyanine Green Fluorescence Imaging Used to Predict Anastomotic Leakage Focused on Rectal Stump During Laparoscopic Anterior Resection

Iwamoto

Matsuda

Hayami

et al. 2020

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: Anastomotic leakage (AL) is arguably the most troublesome complication of anterior resection (AR). In recent years, however, indocyanine green (ICG) fluorescence imaging has been recently used to evaluate blood flow in the anastomosis site, and it has been suggested that AL may be predicted. We reported the effectiveness of predicting AL in colorectal cancer surgery by observing a quantitative laparoscopic ICG fluorescence imaging for the first time. The purpose of this study was to predict the risk of postoperative AL by quantitative laparoscopic ICG fluorescence imaging focused on the rectal stamp, which is one of the major causes of AL in AR, and to construct diverting stoma (DS) only in appropriate cases. Methods: We studied the 25 patients who underwent elective laparoscopic AR for rectal cancer at our hospital between July 2016 and June 2017. Before enforcing double-stapling technique anastomosis, we injected ICG intravenously, and laparoscopically evaluated blood flow on the rectal stump. We analyzed quantitatively the relationship between various parameters and AL. Results: Median T0, from when the ICG was injected intravenously and the ICG disappeared from the injection route to the rise of the histogram of intensity, in AL group was significantly longer than that in non-AL group (P = .03). There were no other significant differences between AL and non-AL groups. Conclusions: T0 was longer in patients with AL than in those without. If prolonged T0 can be recognized intraoperatively, it will be possible to construct DS for appropriate patients only.

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Equivocal Effect of Intraoperative Fluorescence Angiography on Colorectal Anastomotic Leaks

Cited by 107 publications

References 13 publications

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

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

Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis

Quantitative Indocyanine Green Fluorescence Imaging Used to Predict Anastomotic Leakage Focused on Rectal Stump During Laparoscopic Anterior Resection

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