Transanal near-infrared imaging of colorectal anastomotic perfusion

The influence of perfusion on colorectal anastomotic healing and, conversely, the role of ischemia in anastomotic dehiscence have been reported by many investigators, and yet identifying a modality that can evaluate perfusion in real time and thus guide intraoperative management has proven elusive. This study describes our initial experience using transanal near-infrared (NIR) imaging to evaluate anastomotic perfusion after colorectal anastomoses. Patients undergoing colectomy with an anastomosis within 25 cm of the anal verge were included in this study. A transanal NIR system was used to assess mucosal perfusion at the level of the anastomoses. The rectum was easily navigated under direct vision and the anastomotic staple line visualized. High-quality NIR mucosal angiography was obtained in all subjects, confirming that transanal NIR angiography is feasible and simple to perform. Although NIR mucosal angiography is a promising modality, further study is needed to correlate this technique to the clinical outcome.