Impact of indocyanine green angiography on anastomotic dehiscence rate in colorectal surgery: a systematic review and meta-analysis of randomized studies

Cirugia espanola Pub Date : 2025-05-01 DOI:10.1016/j.cireng.2024.06.002

Zutoia Balciscueta Coltell , Izaskun Balciscueta Coltell , Natalia Uribe Quintana

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Abstract

Anastomotic dehiscence, a feared complication in colorectal surgery, motivates the search for effective strategies to mitigate its risk. This meta-analysis encompasses all published randomized trials investigating and comparing the impact of indocyanine green (ICG) angiography on this complication. With four studies and 1,109 patients, the intraoperative ICG angiography group demonstrated a significant reduction in the overall rate of anastomotic dehiscence compared to the non-angiography group (7.3% vs. 11.5%; OR: 0.6; 95% CI: 0.4−0.9; p = 0.03). These differences were maintained in rectal surgery subgroup, with no prolongation of surgical time or increase in morbidity and mortality. There were no differences in the left colon surgery group. The evidence provided by this meta-analysis would support the effectiveness of ICG angiography in reducing the incidence of anastomotic leakage in colorectal surgery, advocating for its integration into routine surgical practice.

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吲哚菁绿血管造影对结直肠手术吻合口开裂率的影响：随机研究的系统回顾和荟萃分析。

最终版本吻合口裂开是结直肠手术中一种可怕的并发症，促使人们寻找有效的策略来降低其风险。这项荟萃分析涵盖了所有已发表的随机试验，这些试验调查并比较了吲哚青绿（ICG）血管造影术对这种并发症的影响。在四项研究和 1,109 名患者中，术中 ICG 血管造影组比非血管造影组显著降低了吻合口开裂的总发生率（7.3% 对 11.5%；OR：0.6；95% CI：0.4-0.9；P = 0.03）。这些差异在直肠手术亚组中保持不变，手术时间没有延长，发病率和死亡率也没有增加。左结肠手术组没有差异。该荟萃分析提供的证据支持 ICG 血管造影在降低结直肠手术吻合口漏发生率方面的有效性，主张将其纳入常规手术实践中。

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Cirugia espanola

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