Intraoperative angiography with indocyanine green to assess anastomosis perfusion in patients undergoing laparoscopic colorectal resection

Abstract

Background:Intraoperative Indocyanine green (ICG) angiography can be used to find a good perfusion segment before the colon cut. The most lethal post-operative complication in colorectal surgery, anastomotic leaking frequently has disastrous clinical outcomes for the patient and has a significant financial impact on the healthcare provider.We create a real-time angiography based on the capacity of ICG to fluoresce when stimulated by near-infrared light when given intravenously. This allows us to assess perfusion of the bowel both before and after the anastomosis. Aim of the work: The Aim of this study is to assess the perfusion of the bowel using indocyanine green dye before and after the anastomosis in patients doing colorectal surgeries.Patients and methods: Prospective clinical study between 1 Dec 2021 to 1 June 2023.This study was conducted on 40 patients admitted to Laparoscopic unit in Minia university hospital.Patients are classified into 2 groups : negative leak group (30 patients) and positive leak group (10 patients).Result: there is a prominent difference between the 2 groups related to smocking and the anastomosis level. Smoking >40 packs per year is higher in the positive leak group.And anastomosis level<5cm from anal verge is higher in the positive leak group.and no significant difference between 2 groups regarding the other data.Conclusion ICG-enhanced fluorescence imaging is a secure and useful method for improving visibility during laparoscopic surgery. ICG dye can be used intraoperative to assess the anastomotic perfusion to decrease post operative anastomotic leakage. Key words: ICG dye, anastomotic leakage, cancer colon.