Impacto de la angiografía con verde de indocianina en la tasa de dehiscencia anastomótica en cirugía colorrectal. Revisión sistemática y metaanálisis de estudios aleatorizados

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola Pub Date : 2025-05-01 DOI:10.1016/j.ciresp.2024.05.002

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 = .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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绿色靛蓝素血管造影对结肠直肠手术中闭合扩张率的影响。对随机研究的系统审查和荟萃分析

吻合口裂是结直肠手术中一种令人恐惧的并发症，它促使人们寻找有效的策略来降低其风险。本荟萃分析包括所有已发表的随机试验，调查和比较吲哚菁绿（ICG）血管造影对该并发症的影响。在4项研究和1109例患者中，术中ICG血管造影组显示，与非血管造影组相比，吻合口开裂的总体发生率显著降低(7.3% vs 11.5%；OR: 0.6;95% ci: 0.4-0.9；p = .03)。这些差异在直肠手术亚组中保持不变，没有延长手术时间或增加发病率和死亡率。左结肠手术组无差异。本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，提倡将其纳入常规手术实践。

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来源期刊

Cirugia Espanola SURGERY-

CiteScore

1.20

自引率

21.10%

发文量

173

审稿时长

53 days

期刊介绍： Cirugía Española, an official body of the Asociación Española de Cirujanos (Spanish Association of Surgeons), will consider original articles, reviews, editorials, special articles, scientific letters, letters to the editor, and medical images for publication; all of these will be submitted to an anonymous external peer review process. There is also the possibility of accepting book reviews of recent publications related to General and Digestive Surgery.