File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Intraoperative use of fluorescence with indocyanine green reduces anastomotic leak rates in rectal cancer surgery: an individual participant data analysis

TitleIntraoperative use of fluorescence with indocyanine green reduces anastomotic leak rates in rectal cancer surgery: an individual participant data analysis
Authors
KeywordsAnastomotic leak
Fluorescence imaging
Indocyanine green
Rectal cancer
Rectal surgery
Issue Date2020
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/
Citation
Surgical Endoscopy, 2020, Epub 2020-06-18 How to Cite?
AbstractBackground: Fluorescence imaging by means of Indocyanine green (ICG) has been applied to intraoperatively determine the perfusion of the anastomosis. The purpose of this Individual Participant Database meta-analysis was to assess the effectiveness in decreasing the incidence of anastomotic leak (AL) after rectal cancer surgery. Methods: We searched PubMed, Embase, Cochrane Library and ClinicalTrial.gov, EU Clinical Trials and ISRCTN registries on September 1st, 2019. We considered eligible those studies comparing the assessment of anastomotic perfusion during rectal cancer surgery by intraoperative use of ICG fluorescence compared with standard practice. We defined as primary outcome the incidence of AL at 30 days after surgery. The studies were assessed for quality by means of the ROBINS-I and the Cochrane risk tools. We calculated odds ratios (ORs) using the Individual patient data analysis, restricted to rectal lesions, according to original treatment allocation. Results: The review of the literature and international registries produced 15 published studies and 5 ongoing trials, for 9 of which the authors accepted to share individual participant data. 314 patients from two randomized trials, 452 from three prospective series and 564 from 4 non-randomized studies were included. Fluorescence imaging significantly reduced the incidence of AL (OR 0.341; 95% CI 0.220–0.530; p < 0.001), independent of age, gender, BMI, tumour and anastomotic distance from the anal verge and neoadjuvant therapy. Also, overall morbidity and reintervention rate were positively influenced by the use of ICG. Conclusions: The incidence of AL may be reduced when ICG fluorescence imaging is used to assess the perfusion of a colorectal anastomosis. Limitations relate to the consistent number of non-randomized studies included and their heterogeneity in defining and assessing AL. Ongoing large randomized studies will help to determine the exact role of routine ICG fluorescence imaging may decrease the incidence of AL in surgery for rectal cancer.
Persistent Identifierhttp://hdl.handle.net/10722/283738
ISSN
2020 Impact Factor: 4.584
2015 SCImago Journal Rankings: 1.695
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorArezzo, A-
dc.contributor.authorBonino, MA-
dc.contributor.authorRis, F-
dc.contributor.authorBoni, L-
dc.contributor.authorCassinotti, E-
dc.contributor.authorFoo, DCC-
dc.contributor.authorShum, NF-
dc.contributor.authorBrolese, A-
dc.contributor.authorCiarleglio, F-
dc.contributor.authorKeller, DS-
dc.contributor.authorRosati, R-
dc.contributor.authorDe Nardi, P-
dc.contributor.authorElmore, U-
dc.contributor.authorRomario, UF-
dc.contributor.authorJafari, MD-
dc.contributor.authorPigazzi, A-
dc.contributor.authorRybakov, E-
dc.contributor.authorAlekseev, M-
dc.contributor.authorWatanabe, J-
dc.contributor.authorVettoretto, N-
dc.contributor.authorCirocchi, R-
dc.contributor.authorPassera, R-
dc.contributor.authorForcignanò, E-
dc.contributor.authorMorino, Mario-
dc.date.accessioned2020-07-03T08:23:24Z-
dc.date.available2020-07-03T08:23:24Z-
dc.date.issued2020-
dc.identifier.citationSurgical Endoscopy, 2020, Epub 2020-06-18-
dc.identifier.issn0930-2794-
dc.identifier.urihttp://hdl.handle.net/10722/283738-
dc.description.abstractBackground: Fluorescence imaging by means of Indocyanine green (ICG) has been applied to intraoperatively determine the perfusion of the anastomosis. The purpose of this Individual Participant Database meta-analysis was to assess the effectiveness in decreasing the incidence of anastomotic leak (AL) after rectal cancer surgery. Methods: We searched PubMed, Embase, Cochrane Library and ClinicalTrial.gov, EU Clinical Trials and ISRCTN registries on September 1st, 2019. We considered eligible those studies comparing the assessment of anastomotic perfusion during rectal cancer surgery by intraoperative use of ICG fluorescence compared with standard practice. We defined as primary outcome the incidence of AL at 30 days after surgery. The studies were assessed for quality by means of the ROBINS-I and the Cochrane risk tools. We calculated odds ratios (ORs) using the Individual patient data analysis, restricted to rectal lesions, according to original treatment allocation. Results: The review of the literature and international registries produced 15 published studies and 5 ongoing trials, for 9 of which the authors accepted to share individual participant data. 314 patients from two randomized trials, 452 from three prospective series and 564 from 4 non-randomized studies were included. Fluorescence imaging significantly reduced the incidence of AL (OR 0.341; 95% CI 0.220–0.530; p < 0.001), independent of age, gender, BMI, tumour and anastomotic distance from the anal verge and neoadjuvant therapy. Also, overall morbidity and reintervention rate were positively influenced by the use of ICG. Conclusions: The incidence of AL may be reduced when ICG fluorescence imaging is used to assess the perfusion of a colorectal anastomosis. Limitations relate to the consistent number of non-randomized studies included and their heterogeneity in defining and assessing AL. Ongoing large randomized studies will help to determine the exact role of routine ICG fluorescence imaging may decrease the incidence of AL in surgery for rectal cancer.-
dc.languageeng-
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00464/-
dc.relation.ispartofSurgical Endoscopy-
dc.rightsThis is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: http://dx.doi.org/[insert DOI]-
dc.subjectAnastomotic leak-
dc.subjectFluorescence imaging-
dc.subjectIndocyanine green-
dc.subjectRectal cancer-
dc.subjectRectal surgery-
dc.titleIntraoperative use of fluorescence with indocyanine green reduces anastomotic leak rates in rectal cancer surgery: an individual participant data analysis-
dc.typeArticle-
dc.identifier.emailFoo, DCC: ccfoo@hku.hk-
dc.identifier.authorityFoo, DCC=rp01899-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00464-020-07735-w-
dc.identifier.pmid32556696-
dc.identifier.scopuseid_2-s2.0-85086573484-
dc.identifier.hkuros310779-
dc.identifier.volumeEpub 2020-06-18-
dc.identifier.isiWOS:000541210800004-
dc.publisher.placeUnited States-
dc.identifier.issnl0930-2794-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats