Blinded Intraoperative Quantitative Indocyanine Green Metrics Associate With Intestinal Margin Acceptance in...

Area of Science:

• Surgical Innovation
• Medical Imaging
• Colorectal Surgery

Background:

• Indocyanine green (ICG) is a valuable tool in colorectal surgery for assessing tissue perfusion.
• Standard subjective interpretation of ICG fluorescence can be variable.
• Quantitative metrics may offer a more standardized and objective approach to ICG analysis.

Discussion:

• This study aimed to validate quantitative ICG metrics against subjective assessments in determining intestinal margin perfusion.
• Surgeons were blinded to quantitative data, ensuring an unbiased comparison with their visual interpretations.
• The findings suggest that objective ICG measurements align well with experienced surgical judgment.

Key Insights:

• Quantitative indocyanine green (ICG) values, specifically maximum fluorescence and time-to-maximum fluorescence, significantly correlated with subjective assessments of intestinal perfusion.
• Accepted perfusion showed higher maximum fluorescence intensity and earlier time-to-maximum fluorescence compared to rejected perfusion (p < 0.01).
• Increased Body Mass Index (BMI) was associated with higher maximum fluorescence, suggesting potential physiological influences.

Outlook:

• Quantitative ICG metrics show promise for enhancing intraoperative assessment of intestinal perfusion in colorectal surgery.
• Further research with larger cohorts is needed to establish a definitive link between quantitative ICG metrics and anastomotic leak rates.
• Future studies should explore the integration of these objective metrics into surgical workflows for improved standardization and outcomes.