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Efficacy of indocyanine green fluorescence angiography in preventing anastomotic leakage after laparoscopic colorectal cancer surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Some recent studies have suggested that fluorescence angiography with indocyanine green (ICG) might be useful for preventing anastomotic leakage (AL) after laparoscopic colorectal surgery. However, its efficacy has not been proven. We evaluated whether intraoperative ICG fluorescence angiography could decrease the AL rate with laparoscopic colorectal cancer surgery.

Methods

This retrospective study included patients with colorectal cancer who underwent laparoscopic surgery at our institution between March 2014 and December 2018. Patients were divided into two groups: with or without ICG fluorescence angiography. The primary outcome was the rate of AL.

Results

A total of 488 patients were included: 223 patients in the ICG group and 265 patients in the no-ICG group. In the ICG group, the transection line was changed to a more proximal location in seven patients (3.1%), including one patient with transverse colon surgery and six with rectal surgery. None of these seven patients developed AL. There were 18 ALs (3.7%) overall. The AL rate was 1.8% in the ICG group and 5.3% in the no-ICG group. For colon cancer, there were no significant differences in the AL rate between the groups (p = 0.278). In rectal cancer, the AL rate was significantly lower in the ICG group than in the no-ICG group (3.5% vs. 10.5%, p = 0.041). After propensity score matching, the AL rate was also significantly lower in the ICG group for rectal cancer (p = 0.044).

Conclusion

ICG fluorescence angiography can potentially reduce the AL rate with laparoscopic rectal cancer surgery.

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Authors and Affiliations

  1. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, S1 W16, Chuo-ku, Sapporo, 060-8543, Japan

    Masayuki Ishii, Atsushi Hamabe, Kenji Okita, Toshihiko Nishidate, Koichi Okuya, Akihiro Usui, Emi Akizuki, Tetsuta Satoyoshi & Ichiro Takemasa

Authors
  1. Masayuki Ishii
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  2. Atsushi Hamabe
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  3. Kenji Okita
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  4. Toshihiko Nishidate
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  5. Koichi Okuya
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  6. Akihiro Usui
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  7. Emi Akizuki
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  8. Tetsuta Satoyoshi
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  9. Ichiro Takemasa
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Corresponding author

Correspondence to Masayuki Ishii.

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The protocol for this study was approved by the institutional review board of Sapporo Medical University Hospital.

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The authors declare that they have no conflicts of interest.

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Ishii, M., Hamabe, A., Okita, K. et al. Efficacy of indocyanine green fluorescence angiography in preventing anastomotic leakage after laparoscopic colorectal cancer surgery. Int J Colorectal Dis 35, 269–275 (2020). https://doi.org/10.1007/s00384-019-03482-0

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