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Article: Colonic perfusion assessment with indocyanine-green fluorescence imaging in anterior resections: a propensity score-matched analysis

TitleColonic perfusion assessment with indocyanine-green fluorescence imaging in anterior resections: a propensity score-matched analysis
Authors
KeywordsIndocyanine-green
Anterior resection
Anastomotic leakage
Total mesorectal excision
Issue Date2020
PublisherSpringer-Verlag Italia Srl. The Journal's web site is located at http://www.springer.it/libri_libro.asp?id=248
Citation
Techniques in Coloproctology, 2020, Epub 2020-05-08 How to Cite?
AbstractBackground: Colonic perfusion is crucial for anastomotic healing and this could be evaluated intraoperatively using indocyanine-green fluorescence imaging (ICG FI). The aim of this study was to ascertain whether the use of ICG FI resulted in the reduction of anastomotic complications, i.e. AL and anastomotic stricture. Methods: Consecutive patients who underwent anterior resections or low anterior resections at our institution in the period from January 1st 2013 to December 31st 2018 were retrospectively reviewed. Surgery performed during the period from January 1st 2013 to December 31st 2015 did not involve the use of ICG FI (ICG−) while surgery during the period from January 1st 2016 to December 31st 2018 was performed with the use of ICG FI (ICG+). The anastomotic leakage rates of the two groups were compared after propensity score matching, taking into account the height of the anastomosis and any history of pelvic irradiation. Results: There was a total of 258 and 317 patients who had surgery with and without ICG FI, respectively. There were 253 patients in each group after propensity score matching. The overall anastomotic leakage rate was 3.6% and 7.9% for ICG+ and ICG−, respectively, (p = 0.035). Subgroup analysis showed that the use of ICG FI was significantly associated with a lower anastomotic leakage rate in total mesorectal excision (TME), 4.7% versus 11.6%, p = 0.043, but not in non-TME resections, 3.5% versus 2.4%, (p = 0.612). ICG FI, together with sex and anastomotic height, were independent predictors of anastomotic leakage. Conclusions: The routine use of ICG FI was associated with a lower anastomotic leakage rate in anterior resections. The reduction in anastomotic leakage rate was mainly seen in TME.
Persistent Identifierhttp://hdl.handle.net/10722/282539
ISSN
2019 Impact Factor: 2.721
2015 SCImago Journal Rankings: 0.959

 

DC FieldValueLanguage
dc.contributor.authorFoo, CC-
dc.contributor.authorNg, KK-
dc.contributor.authorTsang, J-
dc.contributor.authorWei, R-
dc.contributor.authorChow, F-
dc.contributor.authorChan, TY-
dc.contributor.authorLo, O-
dc.contributor.authorLaw, WL-
dc.date.accessioned2020-05-15T05:29:25Z-
dc.date.available2020-05-15T05:29:25Z-
dc.date.issued2020-
dc.identifier.citationTechniques in Coloproctology, 2020, Epub 2020-05-08-
dc.identifier.issn1123-6337-
dc.identifier.urihttp://hdl.handle.net/10722/282539-
dc.description.abstractBackground: Colonic perfusion is crucial for anastomotic healing and this could be evaluated intraoperatively using indocyanine-green fluorescence imaging (ICG FI). The aim of this study was to ascertain whether the use of ICG FI resulted in the reduction of anastomotic complications, i.e. AL and anastomotic stricture. Methods: Consecutive patients who underwent anterior resections or low anterior resections at our institution in the period from January 1st 2013 to December 31st 2018 were retrospectively reviewed. Surgery performed during the period from January 1st 2013 to December 31st 2015 did not involve the use of ICG FI (ICG−) while surgery during the period from January 1st 2016 to December 31st 2018 was performed with the use of ICG FI (ICG+). The anastomotic leakage rates of the two groups were compared after propensity score matching, taking into account the height of the anastomosis and any history of pelvic irradiation. Results: There was a total of 258 and 317 patients who had surgery with and without ICG FI, respectively. There were 253 patients in each group after propensity score matching. The overall anastomotic leakage rate was 3.6% and 7.9% for ICG+ and ICG−, respectively, (p = 0.035). Subgroup analysis showed that the use of ICG FI was significantly associated with a lower anastomotic leakage rate in total mesorectal excision (TME), 4.7% versus 11.6%, p = 0.043, but not in non-TME resections, 3.5% versus 2.4%, (p = 0.612). ICG FI, together with sex and anastomotic height, were independent predictors of anastomotic leakage. Conclusions: The routine use of ICG FI was associated with a lower anastomotic leakage rate in anterior resections. The reduction in anastomotic leakage rate was mainly seen in TME.-
dc.languageeng-
dc.publisherSpringer-Verlag Italia Srl. The Journal's web site is located at http://www.springer.it/libri_libro.asp?id=248-
dc.relation.ispartofTechniques in Coloproctology-
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.subjectIndocyanine-green-
dc.subjectAnterior resection-
dc.subjectAnastomotic leakage-
dc.subjectTotal mesorectal excision-
dc.titleColonic perfusion assessment with indocyanine-green fluorescence imaging in anterior resections: a propensity score-matched analysis-
dc.typeArticle-
dc.identifier.emailFoo, CC: ccfoo@hku.hk-
dc.identifier.emailNg, KK: ngkakin@hku.hk-
dc.identifier.emailTsang, J: julianst@HKUCC-COM.hku.hk-
dc.identifier.emailWei, R: rwei@hku.hk-
dc.identifier.emailLo, O: oswens@hku.hk-
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hk-
dc.identifier.authorityFoo, CC=rp01899-
dc.identifier.authorityLaw, WL=rp00436-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s10151-020-02232-7-
dc.identifier.pmid32385673-
dc.identifier.scopuseid_2-s2.0-85084482725-
dc.identifier.hkuros309929-
dc.identifier.volumeEpub 2020-05-08-
dc.publisher.placeItaly-

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