A comparative study on the use of indocyanine-green fluorescence angiogram during left-sided colonic resections

Abstract

Aim: Colonic perfusion is crucial for anastomotic healing and this could be mea-sured by indocyanine-green fluorescence angiogram (ICG FA). The aim of thisstudy was to ascertain whether the use of ICG FA reduced anastomotic leakage.Method: Patients who underwent anterior resections (AR) and low anterior resec-tions (LAR) were retrospectively reviewed. Surgery performed during the period2013 to 2015 (period A) did not involve the use of ICG FA while surgery during2016 to 2018 (period B) was performed with the use of ICG FA. The anastomoticleakage rates from the two periods were compared.Results: There were a total of 323 and 241 patients who had surgery during periodA and period B respectively. During period A, 64.1% were male patients. 34.7% and65.3% were AR and LAR respectively. During period B, 63.9% were male patients.There were 50.2% and 49.8% AR and LAR respectively. The anastomotic leakagerate was 4.0% and 2.1% for period A and period B respectively, P = 0.192 odd ratio0.51, 95% CI 0.18–1.43.Conclusion: With th e use of ICG FA, the anastomotic leakage rate was lower.However, the difference did not reach statistical significance. Studies with largersample size could hopefully address this question.