M Alekseev1,2, E Rybakov1, Y Shelygin1,2, S Chernyshov1, I Zarodnyuk1. 1. State Scientific Centre of Coloproctology, Moscow, Russia. 2. Russian Medical Academy of Continuous Professional Education, Moscow, Russia.
Abstract
AIM: Our aim was to evaluate the efficacy of indocyanine green (ICG) fluorescence angiography (FA) in reducing the incidence of anastomotic leakage (AL) following colorectal anastomosis. METHOD: A single-centre randomized trial was undertaken between 2018 and 2019. Those patients who underwent a stapled colorectal anastomosis were randomized 1:1 for ICG FA versus visual clinical assessment of blood perfusion of the anastomosed colon and rectal stump (non-ICG FA group). The primary end-point was to assess whether ICG FA was associated with a reduction in the incidence of AL. Secondary outcomes were the rate of postoperative complications and change in the level of bowel resection. RESULTS: A total of 380 patients undergoing sigmoid and rectal resection were enrolled. After randomization, three patients were excluded. The results of 377 cases were available for analysis; 187 had ICG FA and 190 were in the non-ICG FA group. ICG FA identified impaired blood perfusion of the colon in 36 (19%) cases. An AL (grade A, B or C) developed in 48 patients: 17 (9.1%) in the ICG FA group and 31 (16.3%) in the non-ICG FA group (P = 0.04). ICG FA did not decrease the rate of AL of high anastomoses (9-15 cm from the anal verge), at 1.3% vs 4.6% in the non-ICG FA group (P = 0.37). In contrast, a decrease in AL rate was found for low (4-8 cm) colorectal anastomoses (14.4% in ICG FA vs 25.7% in the non-ICG FA group; P = 0.04). CONCLUSION:ICG FA is associated with a reduction in AL following low anterior resection.
RCT Entities:
AIM: Our aim was to evaluate the efficacy of indocyanine green (ICG) fluorescence angiography (FA) in reducing the incidence of anastomotic leakage (AL) following colorectal anastomosis. METHOD: A single-centre randomized trial was undertaken between 2018 and 2019. Those patients who underwent a stapled colorectal anastomosis were randomized 1:1 for ICG FA versus visual clinical assessment of blood perfusion of the anastomosed colon and rectal stump (non-ICG FA group). The primary end-point was to assess whether ICG FA was associated with a reduction in the incidence of AL. Secondary outcomes were the rate of postoperative complications and change in the level of bowel resection. RESULTS: A total of 380 patients undergoing sigmoid and rectal resection were enrolled. After randomization, three patients were excluded. The results of 377 cases were available for analysis; 187 had ICG FA and 190 were in the non-ICG FA group. ICG FA identified impaired blood perfusion of the colon in 36 (19%) cases. An AL (grade A, B or C) developed in 48 patients: 17 (9.1%) in the ICG FA group and 31 (16.3%) in the non-ICG FA group (P = 0.04). ICG FA did not decrease the rate of AL of high anastomoses (9-15 cm from the anal verge), at 1.3% vs 4.6% in the non-ICG FA group (P = 0.37). In contrast, a decrease in AL rate was found for low (4-8 cm) colorectal anastomoses (14.4% in ICG FA vs 25.7% in the non-ICG FA group; P = 0.04). CONCLUSION:ICG FA is associated with a reduction in AL following low anterior resection.
Authors: H Hasegawa; Y Tsukada; M Wakabayashi; S Nomura; T Sasaki; Y Nishizawa; K Ikeda; N Takeshita; K Teramura; M Ito Journal: Tech Coloproctol Date: 2022-05-16 Impact factor: 3.699
Authors: Kamil Safiejko; Radoslaw Tarkowski; Tomasz Piotr Kozlowski; Maciej Koselak; Marcin Jachimiuk; Aleksander Tarasik; Michal Pruc; Jacek Smereka; Lukasz Szarpak Journal: Cancers (Basel) Date: 2022-02-18 Impact factor: 6.639
Authors: Gian Luca Baiocchi; Gianluca Guercioni; Nereo Vettoretto; Stefano Scabini; Paolo Millo; Andrea Muratore; Marco Clementi; Giuseppe Sica; Paolo Delrio; Graziano Longo; Gabriele Anania; Vittoria Barbieri; Pietro Amodio; Carlo Di Marco; Gianandrea Baldazzi; Gianluca Garulli; Alberto Patriti; Felice Pirozzi; Raffaele De Luca; Stefano Mancini; Corrado Pedrazzani; Matteo Scaramuzzi; Marco Scatizzi; Lucio Taglietti; Michele Motter; Graziano Ceccarelli; Mauro Totis; Andrea Gennai; Diletta Frazzini; Gianluca Di Mauro; Gabriella Teresa Capolupo; Francesco Crafa; Pierluigi Marini; Giacomo Ruffo; Roberto Persiani; Felice Borghi; Nicolò de Manzini; Marco Catarci Journal: BMC Surg Date: 2021-04-10 Impact factor: 2.102
Authors: Niall P Hardy; Jeffrey Dalli; Mohammad Faraz Khan; Predrag Andrejevic; Peter M Neary; Ronan A Cahill Journal: Surg Endosc Date: 2021-01-04 Impact factor: 4.584
Authors: Nikolaj Nerup; Morten Bo Søndergaard Svendsen; Jonas Hedelund Rønn; Lars Konge; Lars Bo Svendsen; Michael Patrick Achiam Journal: Surg Endosc Date: 2021-05-03 Impact factor: 4.584