Indocyanine green fluorescence angiography in colorectal surgery: A retrospective case-control analysis in Mexico.

INTRODUCTION AND AIMS: An anastomotic leak is one of the most dreaded complications in colorectal surgery because it increases postoperative morbidity and mortality. The aim of the present study was to identify whether indocyanine green fluorescence angiography (ICGFA) reduced the anastomotic dehiscence rate in colorectal surgery. MATERIAL AND METHODS: A retrospective study on patients that underwent colorectal surgery with colonic resection or low anterior resection and primary anastomosis, within the time frame of January 2019 and September 2021, was conducted. The patients were divided into the case group, in which ICGFA was performed for the intraoperative evaluation of blood perfusion at the anastomosis site, and the control group, in which ICGFA was not utilized. RESULTS: A total of 168 medical records were reviewed, resulting in 83 cases and 85 controls. Inadequate perfusion that required changing the surgical site of the anastomosis was identified in 4.8% of the case group (n = 4). A trend toward reducing the leak rate with ICGFA was identified (6% [n = 5] in the cases vs 7.1% in the controls [n = 6] [p = 0.999]). The patients that underwent anastomosis site change due to inadequate perfusion had a 0% leak rate. CONCLUSIONS: ICGFA as a method to evaluate intraoperative blood perfusion showed a trend toward reducing the incidence of anastomotic leak in colorectal surgery.

Indocyanine green fluorescence angiography in colorectal surgery. First case series in Mexico.

INTRODUCTION AND AIM: Anastomosis leak occurs in 1-19% of colorrectal surgeries. Our objective was to present the first Mexican case series on colorrectal surgery using indocyanine green fluorescence angiography to evaluate perfusion prior to carrying out the anastomosis. MATERIALS AND METHODS: A retrospective, analytic, descriptive study was conducted. We studied the case records of consecutive patients that underwent colorrectal surgery with indocyanine green angiography performed by the same group of colorrectal surgeons. RESULTS: Twenty-one case records were reviewed. Eleven (52.3%) of the patients were women, mean patient age was 57 years (38-82), and mean body mass index was 25 kg/m2 (17-34). Fifteen (71.4%) patients were diagnosed with malignant disease. Indocyanine green angiography changed our therapeutic decision in three (14.2%) patients. Two colorrectal anastomoses (14.2%) were performed at fewer than 5 cm from the anal verge and 13 (61.9%) were performed at more than 5 cm from the anal verge. Three of the anastomoses were ileocolic (14.2%), two were coloanal (9.5%), and one was ileoanal (4.7%). There were six (28.5%) complications, no cases of anastomotic leak, and no complications associated with the use of indocyanine green. The mortality rate was 0%. CONCLUSION: The present case series is the first on colorrectal surgery conducted in Mexico using indocyanine green fluorescence angiography, with excellent results.

Indocyanine green fluorescence angiography in colorrectal surgery. First case series in Mexico. / Angiografía por fluorescencia con verde de indocianina para cirugía de colon y recto. Primera serie reportada en México.

INTRODUCTION AND AIM: Anastomotic leak occurs in 1-19% of colorrectal surgeries. Our objective was to present the first Mexican case series on colorrectal surgery using indocyanine green fluorescence angiography to evaluate perfusion prior to carrying out the anastomosis. MATERIALS AND METHODS: A retrospective, analytic, descriptive study was conducted. We studied the case records of consecutive patients that underwent colorrectal surgery with indocyanine green angiography performed by the same group of colorrectal surgeons. RESULTS: Twenty-one case records were reviewed. Eleven (52.3%) of the patients were women, mean patient age was 57 years (38-82), and mean body mass index was 25 kg/m2 (17-34). Fifteen (71.4%) patients were diagnosed with malignant disease. Indocyanine green angiography changed our therapeutic decision in three (14.2%) patients. Two colorrectal anastomoses (14.2%) were performed at fewer than 5 cm from the anal verge and 13 (61.9%) were performed at more than 5 cm from the anal verge. Three of the anastomoses were ileocolic (14.2%), two were coloanal (9.5%), and one was ileoanal (4.7%). There were six (28.5%) complications, no cases of anastomotic leak, and no complications associated with the use of indocyanine green. The mortality rate was 0%. CONCLUSION: The present case series is the first on colorrectal surgery conducted in Mexico using indocyanine green fluorescence angiography, with excellent results.