Tueme-de la Peña D, Salgado-Gamboa E A, Ortiz de Elguea-Lizárraga J I, Zambrano Lara M, Rangel-Ríos H A, Chapa-Lobo A F, Salgado-Cruz L E
Hospital Christus Muguerza Alta Especialidad - UDEM, Monterrey, Nuevo León, Mexico.
Coloncare, Hospital Ángeles Valle Oriente, San Pedro Garza García, Nuevo León, Mexico.
Rev Gastroenterol Mex (Engl Ed). 2024 Apr-Jun;89(2):186-193. doi: 10.1016/j.rgmxen.2023.02.003. Epub 2023 Mar 6.
An anastomotic leak is one of the most dreaded complications in colorectal surgery because it increases postoperative morbidity and mortality. The aim of the present study was to identify whether indocyanine green fluorescence angiography (ICGFA) reduced the anastomotic dehiscence rate in colorectal surgery.
A retrospective study on patients that underwent colorectal surgery with colonic resection or low anterior resection and primary anastomosis, within the time frame of January 2019 and September 2021, was conducted. The patients were divided into the case group, in which ICGFA was performed for the intraoperative evaluation of blood perfusion at the anastomosis site, and the control group, in which ICGFA was not utilized.
A total of 168 medical records were reviewed, resulting in 83 cases and 85 controls. Inadequate perfusion that required changing the surgical site of the anastomosis was identified in 4.8% of the case group (n = 4). A trend toward reducing the leak rate with ICGFA was identified (6% [n = 5] in the cases vs 7.1% in the controls [n = 6] [p = 0.999]). The patients that underwent anastomosis site change due to inadequate perfusion had a 0% leak rate.
ICGFA as a method to evaluate intraoperative blood perfusion showed a trend toward reducing the incidence of anastomotic leak in colorectal surgery.
吻合口漏是结直肠手术中最可怕的并发症之一，因为它会增加术后发病率和死亡率。本研究的目的是确定吲哚菁绿荧光血管造影（ICGFA）是否能降低结直肠手术中的吻合口裂开率。
对2019年1月至2021年9月期间接受结肠切除术或低位前切除术并进行一期吻合的结直肠手术患者进行回顾性研究。患者分为病例组和对照组，病例组术中采用ICGFA评估吻合口部位的血流灌注，对照组未使用ICGFA。
共审查了168份病历，其中83例为病例组，85例为对照组。病例组中有4.8%（n = 4）的患者出现灌注不足，需要改变吻合口的手术部位。发现ICGFA有降低漏率的趋势（病例组为6% [n = 5]，对照组为7.1% [n = 6] [p = 0.999]）。因灌注不足而更换吻合口部位的患者漏率为0%。
ICGFA作为一种评估术中血流灌注的方法，在结直肠手术中显示出降低吻合口漏发生率的趋势。
