Does indocyanine green fluorescence angiography reduce the risk of anastomotic leaks in colorectal resections?

• Verfasst von: Elmajdub, Ahmed [VerfasserIn]
• Verfasst von: Brebesh, Nahed [VerfasserIn]
• Verfasst von: Maatough, Annis [VerfasserIn]
• Verfasst von: Willeke, Frank [VerfasserIn]
• Verfasst von: Weiß, Christel [VerfasserIn]
• Verfasst von: Darwich, Ibrahim [VerfasserIn]
• Titel: Does indocyanine green fluorescence angiography reduce the risk of anastomotic leaks in colorectal resections?
• Titelzusatz: A systematic review and meta-analysis of randomized controlled trials
• Verf.angabe: Ahmed Elmajdub, Nahed Brebesh, Annis Maatough, Frank Willeke, Christel Weiss, Ibrahim Darwich
• Jahr: 2025
• Umfang: 13 S.
• Illustrationen: Illustrationen
• Fussnoten: Veröffentlicht: 02. Dezember 2024 ; Gesehen am 12.03.2025
• Titel Quelle: Enthalten in: Updates in surgery
• Ort Quelle: Mailand : Springer Milan, 2010
• Jahr Quelle: 2025
• Band/Heft Quelle: 77(2025), Seite 83-95
• ISSN Quelle: 2038-3312
• DOI: doi:10.1007/s13304-024-02036-6
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Anastomotic leak
• Sach-SW: Colectomy
• Sach-SW: Colorectal resection
• Sach-SW: Fluorescence angiography
• Sach-SW: Hemicolectomy
• Sach-SW: Indocyanine green
• K10plus-PPN: 1919639217

Abstract

Anastomotic leaks are a significant complication in colorectal surgery. Indocyanine green fluorescence angiography (ICG-FA) has been suggested as a method to reduce the risk. This meta-analysis aims to evaluate the effect of ICG-FA on reducing anastomotic leaks in colorectal surgery. This study follows PRISMA guidelines and is registered on PROSPERO (CRD42022370748). We conducted a comprehensive search of multiple databases and registers for randomized controlled trials (RCTs) comparing ICG-FA with standard methods in colorectal surgery. Data extraction and quality assessment were performed by two independent reviewers, with a third resolving disputes. Odds ratios (OR) and mean differences (MD) were calculated using comprehensive meta-analysis software, version 3. Heterogeneity and publication bias were assessed, and a sensitivity analysis was performed. The analysis included five RCTs with a total of 1369 patients from four countries. The ICG-FA was associated with a 45% reduction in the risk of overall anastomotic leaks (OR: 0.550, p = 0.012). Subgroup analysis showed a 47% reduction in leaks for low anastomoses (OR: 0.53, p = 0.143) and a 69% reduction in grade A leaks (OR: 0.31, p = 0.008). No significant effects were observed for grade B and C leaks, blood loss, surgery duration, hospital stay, mortality, postoperative ileus, reoperation, or surgical site infections. ICG-FA significantly reduces the overall risk of anastomotic leaks, especially grade A leaks, and shows a trend towards fewer leaks in low anastomosis. No significant impact was found on secondary outcomes. Further RCTs are needed to confirm these findings.