Evaluation of Long-Term Outcomes Utilizing Indocyanine Green to Decrease Ureteroenteric Anastomotic Stricture During...

Area of Science:

• Urology
• Surgical Oncology
• Medical Imaging

Background:

• Ureteroenteric anastomotic stricture (UAS) is a complication after robot-assisted radical cystectomy (RARC) with extracorporeal urinary diversion (ECUD).
• Assessing ureteral perfusion during ureteroenteric anastomosis is crucial for preventing UAS.

Purpose of the Study:

• To evaluate the impact of indocyanine green (ICG) use on UAS risk.
• To identify clinical factors associated with UAS incidence following RARC and ECUD.

Main Methods:

• Retrospective review of 392 patients undergoing RARC + ECUD (2011-2022).
• Comparison of outcomes between patients who received ICG and those who did not.
• Kaplan-Meier and logistic regression analyses to determine UAS rates and risk factors.

Main Results:

• ICG use was associated with significantly lower UAS rates (2% at 6 months vs. 12% in non-ICG group).
• Diabetes mellitus was identified as a significant risk factor for increased UAS incidence.
• No adverse events related to ICG administration were reported.

Conclusions:

• ICG fluorescence imaging is a safe and effective tool for reducing UAS risk after RARC and ECUD.
• Utilizing ICG can improve surgical outcomes by ensuring adequate ureteral perfusion during anastomosis.