Volume 90, Issue 11 pp. 2193-2200

REVIEW ARTICLE

Intraoperative indocyanine green fluorescence angiography to prevent anastomotic leak after low anterior resection for rectal cancer: a meta-analysis

Yu Shen MD,

Yu Shen MD

orcid.org/0000-0002-0167-458X

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

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Tinghan Yang MD, PhD,

Tinghan Yang MD, PhD

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

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Jinliang Yang PhD,

Jinliang Yang PhD

State Key Lab of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China

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Wenjian Meng MD, PhD,

Corresponding Author

Wenjian Meng MD, PhD

[email protected]

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

Correspondence

Dr Wenjian Meng, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Guo Xue Xiang 37#, Chengdu, Sichuan Province 610041, China. Email: [email protected]

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Ziqiang Wang MD, PhD,

Ziqiang Wang MD, PhD

orcid.org/0000-0002-2874-1535

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

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Yu Shen MD,

Yu Shen MD

orcid.org/0000-0002-0167-458X

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

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Tinghan Yang MD, PhD,

Tinghan Yang MD, PhD

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

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Jinliang Yang PhD,

Jinliang Yang PhD

State Key Lab of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China

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Wenjian Meng MD, PhD,

Corresponding Author

Wenjian Meng MD, PhD

[email protected]

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

Correspondence

Dr Wenjian Meng, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Guo Xue Xiang 37#, Chengdu, Sichuan Province 610041, China. Email: [email protected]

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Ziqiang Wang MD, PhD,

Ziqiang Wang MD, PhD

orcid.org/0000-0002-2874-1535

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China

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First published: 11 March 2020

https://doi.org/10.1111/ans.15809

Citations: 16

Y. Shen MD; T. Yang MD, PhD; J. Yang PhD; W. Meng MD, PhD; Z. Wang MD, PhD.

Yu Shen and Tinghan Yang contributed equally to this study and should be considered co-first authors.

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Abstract

Background

Anastomotic leakage (AL) is one of the most dreadful complications after rectal cancer surgery. Indocyanine green fluorescence angiography (ICG FA) is now being used to evaluate blood supply at the anastomotic site. The aim of this study is to conduct a meta-analysis of the available literature to evaluate whether ICG FA could prevent AL after low anterior resection (LAR) for rectal cancer.

Methods

Databases including PubMed, Web of Science, Google Scholar databases, Cochrane Library and China National Knowledge Infrastructure were searched to find out potential comparative studies comparing AL rates after LAR between intraoperative use and non-use of ICG FA.

Results

A total of 1499 patients undergoing LAR in six studies were included. Intraoperative use of ICG FA was associated with lower AL rate (odds ratio (OR) 0.30; 95% confidence interval (CI) 0.19–0.49; P < 0.001; I² = 0%), overall post-operative complication rate (OR 0.46; 95% CI 0.30–0.70; P < 0.001; I² = 0%) and reoperation rate (OR 0.21; 95% CI 0.06–0.75; P = 0.020; I² = 0%). The initial transection line was changed in 7.62% (31/407) of patients in the ICG group and 19.35% (6/31) of patients suffered AL. In transection line unchanged patients (376/407), 5.05% (19/376) of patients suffered AL.

Conclusion

Intraoperative use of ICG FA is associated with lower incidence of AL after LAR. The benefit of ICG FA may be that it could identify patients with high risk for AL.

Conflicts of interest

There are no conflicts of interest.

Supporting Information

References

1Ellebaek MB, Rahr HB, Boye S, Fristrup C, Qvist N. Detection of early anastomotic leakage by intraperitoneal microdialysis after low anterior resection for rectal cancer: a prospective cohort study. Colorectal Dis. 2019; 21: 1387–96.
10.1111/codi.14781
CAS PubMed Web of Science® Google Scholar
2Watanabe J, Ishibe A, Suwa Y et al. Indocyanine green fluorescence imaging to reduce the risk of anastomotic leakage in laparoscopic low anterior resection for rectal cancer: a propensity score-matched cohort study. Surg. Endosc. 2020; 34: 202–8.
10.1007/s00464-019-06751-9
PubMed Web of Science® Google Scholar
3Sverrisson I, Folkvaljon F, Chabok A, Stattin P, Smedh K, Nikberg M. Anastomotic leakage after anterior resection in patients with rectal cancer previously irradiated for prostate cancer. Eur. J. Surg. Oncol. 2019; 45: 341–6.
10.1016/j.ejso.2018.11.015
PubMed Web of Science® Google Scholar
4Haskins IN, Fleshman JW, Amdur RL, Agarwal S. The impact of bowel preparation on the severity of anastomotic leak in colon cancer patients. J. Surg. Oncol. 2016; 114: 810–3.
10.1002/jso.24426
PubMed Web of Science® Google Scholar
5Frasson M, Flor-Lorente B, Rodriguez JL et al. Risk factors for anastomotic leak after colon resection for cancer: multivariate analysis and nomogram from a multicentric, prospective, national study with 3193 patients. Ann. Surg. 2015; 262: 321–30.
10.1097/SLA.0000000000000973
PubMed Web of Science® Google Scholar
6Gessler B, Eriksson O, Angenete E. Diagnosis, treatment, and consequences of anastomotic leakage in colorectal surgery. Int. J. Colorectal Dis. 2017; 32: 549–56.
10.1007/s00384-016-2744-x
PubMed Web of Science® Google Scholar
7Park JS, Choi GS, Kim SH et al. Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision: the Korean laparoscopic colorectal surgery study group. Ann. Surg. 2013; 257: 665–71.
10.1097/SLA.0b013e31827b8ed9
PubMed Web of Science® Google Scholar
8Liu J, Huang L, Wang N, Chen P. Indocyanine green detects sentinel lymph nodes in early breast cancer. J. Int. Med. Res. 2017; 45: 514–24.
10.1177/0300060516687149
PubMed Web of Science® Google Scholar
9Kim JC, Lee JL, Yoon YS, Alotaibi AM, Kim J. Utility of indocyanine-green fluorescent imaging during robot-assisted sphincter-saving surgery on rectal cancer patients. Int. J. Med. Robot 2016; 12: 710–7.
10.1002/rcs.1710
PubMed Web of Science® Google Scholar
10Boni L, Fingerhut A, Marzorati A, Rausei S, Dionigi G, Cassinotti E. Indocyanine green fluorescence angiography during laparoscopic low anterior resection: results of a case-matched study. Surg. Endosc. 2017; 31: 1836–40.
10.1007/s00464-016-5181-6
PubMed Web of Science® Google Scholar
11van den Bos J, Jongen A, Melenhorst J et al. Near-infrared fluorescence image-guidance in anastomotic colorectal cancer surgery and its relation to serum markers of anastomotic leakage: a clinical pilot study. Surg. Endosc. 2019; 33: 3766–74.
10.1007/s00464-019-06673-6
PubMed Web of Science® Google Scholar
12Chang YK, Foo CC, Yip J et al. The impact of indocyanine-green fluorescence angiogram on colorectal resection. Surgeon 2019; 17: 270–6.
10.1016/j.surge.2018.08.006
PubMed Web of Science® Google Scholar
13Blanco-Colino R, Espin-Basany E. Intraoperative use of ICG fluorescence imaging to reduce the risk of anastomotic leakage in colorectal surgery: a systematic review and meta-analysis. Tech. Coloproctol. 2018; 22: 15–23.
10.1007/s10151-017-1731-8
CAS PubMed Web of Science® Google Scholar
14Shen R, Zhang Y, Wang T. Indocyanine green fluorescence angiography and the incidence of anastomotic leak after colorectal resection for colorectal cancer: a meta-analysis. Dis. Colon Rectum 2018; 61: 1228–34.
10.1097/DCR.0000000000001123
PubMed Web of Science® Google Scholar
15Sparreboom CL, van Groningen JT, Lingsma HF et al. Different risk factors for early and late colorectal anastomotic leakage in a nationwide audit. Dis. Colon Rectum 2018; 61: 1258–66.
10.1097/DCR.0000000000001202
PubMed Web of Science® Google Scholar
16Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. J. Clin. Epidemiol. 2009; 62: 1006–12.
10.1016/j.jclinepi.2009.06.005
PubMed Web of Science® Google Scholar
17Katayama H, Kurokawa Y, Nakamura K et al. Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria. Surg. Today 2016; 46: 668–85.
10.1007/s00595-015-1236-x
PubMed Web of Science® Google Scholar
18Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0. [Updated July 2019.] Cochrane, 2019. Available from URL: www.training.cochrane.org/handbook
10.1002/9781119536604
Google Scholar
19Mizrahi I, de Lacy FB, Abu-Gazala M et al. Transanal total mesorectal excision for rectal cancer with indocyanine green fluorescence angiography. Tech. Coloproctol. 2018; 22: 785–91.
10.1007/s10151-018-1869-z
CAS PubMed Web of Science® Google Scholar
20Mizrahi I, Abu-Gazala M, Rickles AS et al. Indocyanine green fluorescence angiography during low anterior resection for low rectal cancer: results of a comparative cohort study. Tech. Coloproctol. 2018; 22: 535–40.
10.1007/s10151-018-1832-z
CAS PubMed Web of Science® Google Scholar
21Jafari MD, Wexner SD, Martz JE et al. Perfusion assessment in laparoscopic left-sided/anterior resection (PILLAR II): a multi-institutional study. J. Am. Coll. Surg. 2015; 220: 82–92.e1.
10.1016/j.jamcollsurg.2014.09.015
PubMed Web of Science® Google Scholar
22Jafari MD, Lee KH, Halabi WJ et al. The use of indocyanine green fluorescence to assess anastomotic perfusion during robotic assisted laparoscopic rectal surgery. Surg. Endosc. 2013; 27: 3003–8.
10.1007/s00464-013-2832-8
PubMed Web of Science® Google Scholar
23Ris F, Liot E, Buchs NC et al. Multicentre phase II trial of near-infrared imaging in elective colorectal surgery. Br. J. Surg. 2018; 105: 1359–67.
10.1002/bjs.10844
CAS PubMed Web of Science® Google Scholar
24Wada T, Kawada K, Hoshino N et al. The effects of intraoperative ICG fluorescence angiography in laparoscopic low anterior resection: a propensity score-matched study. Int. J. Clin. Oncol. 2019; 24: 394–402.
10.1007/s10147-018-1365-5
PubMed Web of Science® Google Scholar
25Lenasi H, Potocnik N, Petrishchev N et al. The measurement of cutaneous blood flow in healthy volunteers subjected to physical exercise with ultrasound Doppler imaging and laser Doppler flowmetry. Clin. Hemorheol. Microcirc. 2017; 65: 373–81.
10.3233/CH-16204
PubMed Web of Science® Google Scholar
26Cianchi F, Indennitate G, Paoli B et al. The clinical value of fluorescent lymphography with indocyanine green during robotic surgery for gastric cancer: a matched cohort study. J. Gastrointest. Surg. 2019.
10.1007/s11605-019-04382-y
PubMed Web of Science® Google Scholar
27Baiocchi GL, Diana M, Boni L. Indocyanine green-based fluorescence imaging in visceral and hepatobiliary and pancreatic surgery: state of the art and future directions. World J. Gastroenterol. 2018; 24: 2921–30.
10.3748/wjg.v24.i27.2921
PubMed Web of Science® Google Scholar
28Terasawa M, Ishizawa T, Mise Y et al. Applications of fusion-fluorescence imaging using indocyanine green in laparoscopic hepatectomy. Surg. Endosc. 2017; 31: 5111–8.
10.1007/s00464-017-5576-z
PubMed Web of Science® Google Scholar
29Lai R, Lu Y, Li Q, Guo J, Chen G, Zeng W. Risk factors for anastomotic leakage following anterior resection for colorectal cancer: the effect of epidural analgesia on occurrence. Int. J. Colorectal Dis. 2013; 28: 485–92.
10.1007/s00384-012-1585-5
CAS PubMed Web of Science® Google Scholar
30Schizas D, Kosmopoulos M, Giannopoulos S et al. Meta-analysis of risk factors and complications associated with atrial fibrillation after oesophagectomy. Br. J. Surg. 2019; 106: 534–47.
10.1002/bjs.11128
CAS PubMed Web of Science® Google Scholar

Citing Literature

Volume90, Issue11

November 2020

Pages 2193-2200

Intraoperative indocyanine green fluorescence angiography to prevent anastomotic leak after low anterior resection for rectal cancer: a meta-analysis

Abstract

Background

Methods

Results

Conclusion

Conflicts of interest

Supporting Information

References

Citing Literature

References

Information

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Intraoperative indocyanine green fluorescence angiography to prevent anastomotic leak after low anterior resection for rectal cancer: a meta-analysis

Abstract

Background

Methods

Results

Conclusion

Conflicts of interest

Supporting Information

References

Citing Literature

References

Related

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