Indocyanine green fluorescence imaging during laparoscopic rectal cancer surgery could reduce the incidence of anastomotic leakage: a single institutional retrospective cohort study

World Journal of Surgical Oncology

Research

Kensuke Kumamoto¹  Eisuke Asano¹  Dongping Feng¹  Akihiro Kondo¹  Keiichi Okano¹  Hideki Kobara² 

[1] Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-Cho, Kita-Gun, 761-0793, Kagawa, Japan;Department of Gastroenterology and Neurology, Kagawa University, Miki-Cho, Kagawa, Japan;

关键词: Anastomotic leakage;    Laparoscopic surgery;    Rectal cancer;    Indocyanine green;    Near-infrared fluorescence imaging;   

DOI  :  10.1186/s12957-022-02856-z

 received in 2022-08-09, accepted in 2022-11-24,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThere is insufficient evidence on whether indocyanine green (ICG) fluorescence angiography can reduce the incidence of anastomotic leakage (AL). This retrospective cohort study aimed to evaluate the effect of ICG fluorescence angiography on AL rates in laparoscopic rectal cancer surgery at a single institution.MethodsPatients who underwent laparoscopic low anterior resection or intersphincteric resection with ICG fluorescence angiography (ICG group; n = 73) and patients who underwent a similar surgical procedure for rectal cancer without ICG fluorescence (non-ICG group; n = 114) were enrolled consecutively in this study. ICG fluorescence angiography was performed prior to transection of the proximal colon, and anastomosis was performed with sufficient perfusion using ICG fluorescence imaging. AL incidence was compared between both groups, and the risk factors for AL were analyzed.ResultsAL occurred in 3 (4.1%) and 14 (12.3%) patients in the ICG and non-ICG groups, respectively. In the ICG group, the median perfusion time from ICG injection was 34 s, and 5 patients (6.8%) required revision of the proximal transection line. None of the patients requiring revision of the proximal transection line developed AL. In univariate analysis, longer operating time (odds ratio: 2.758; 95% confidence interval: 1.023–7.624) and no implementation of ICG fluorescence angiography (odds ratio: 3.266; 95% confidence interval: 1.038–11.793) were significant factors associated with AL incidence, although the creation of a diverting stoma or insertion of a transanal tube was insignificant.ConclusionICG fluorescence angiography was associated with a significant reduction in AL during laparoscopic rectal cancer surgery. Changes in the surgical plan due to ICG fluorescence visibility may help improve the short-term outcomes of patients with rectal cancer.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

Fig. 3