Fluorescent ICG angiography in laparoscopic rectal resection - a randomized controlled trial. Preliminary report

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Medical Imaging

Background:

• Anastomotic leakage is a severe complication following rectal surgery, impacting patient quality of life and oncological outcomes.
• Insufficient blood supply to the anastomosis is a key factor contributing to anastomotic leaks.
• Intraoperative infrared angiography with indocyanine green (ICG) offers a potential solution for assessing intestinal perfusion.

Purpose of the Study:

• To evaluate the efficacy of intraoperative ICG angiography in preventing anastomotic leakage during rectal surgery.

Main Methods:

• A randomized study involving 76 patients undergoing rectal cancer surgery.
• Group I (41 patients) underwent ICG angiography, while Group II (35 patients) did not.
• Comparison of anastomotic leak rates, hospitalization duration, and overall complication rates between the two groups.

Main Results:

• In the ICG group, 7.3% of patients required extended resection due to identified intestinal ischemia, with no anastomotic leaks or side effects.
• The control group experienced 8.6% anastomotic leakage, with two cases necessitating reoperation.
• ICG angiography procedure time averaged 4 minutes, representing 3.2% of total surgical time.

Conclusions:

• Intraoperative ICG angiography is a safe and effective method for evaluating intestinal perfusion during rectal surgery.
• This technique can alter surgical plans and significantly reduce the incidence of anastomotic leakage.
• Further research is warranted to confirm these findings in a larger patient cohort.