Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, China.
Int J Colorectal Dis. 2020 Jun;35(6):1133-1139. doi: 10.1007/s00384-020-03592-0. Epub 2020 Apr 14.
The aim of this study was to evaluate the efficacy of indocyanine green (ICG) fluorescence angiography with respect to the anastomotic leakage rate for patients undergoing colorectal operations.
This prospective cohort involved patients who underwent colorectal surgery between August 2018 and September 2019. ICG was injected after colonic transection. Vascular perfusion was observed by ICG fluorescence system before completing anastomosis. Data was compared with those by subjective visual evaluation. The primary outcome was anastomotic leakage rate within 30 days from surgery.
A total of 131 patients were enrolled, of which ICG was injected in 63 of them. Demographic data were similar between the two groups. There were two (3.23%) and three (4.35%) anastomotic leaks in the ICG and non-ICG group respectively (p = 1.000). Change of resection plane occurred in one patient in the ICG group. There was no ICG related toxicity or adverse events.
ICG fluorescent imaging is a feasible and safe tool to assess colonic vascularisation for patients undergoing colorectal surgery. However, it did not significantly lower the anastomotic leakage rate. ICG should not be routinely used in colorectal surgery before an available large scale randomised controlled trial to prove any clinical benefits.
本研究旨在评估吲哚菁绿（ICG）荧光血管造影术对接受结直肠手术患者吻合口漏发生率的疗效。
这是一项前瞻性队列研究，纳入了 2018 年 8 月至 2019 年 9 月期间接受结直肠手术的患者。在结肠横断后注射 ICG。在完成吻合前，用 ICG 荧光系统观察血管灌注情况。数据与主观视觉评估进行比较。主要结局为术后 30 天内的吻合口漏发生率。
共纳入 131 例患者，其中 63 例注射了 ICG。两组患者的人口统计学数据相似。ICG 组和非 ICG 组分别有 2 例（3.23%）和 3 例（4.35%）吻合口漏（p=1.000）。ICG 组有 1 例患者的切除平面发生变化。没有与 ICG 相关的毒性或不良事件。
ICG 荧光成像技术是一种可行且安全的评估结直肠手术患者结肠血管化的工具，但并未显著降低吻合口漏发生率。在有大型随机对照试验证明其临床获益之前，ICG 不应常规用于结直肠手术。
