Objective:

To evaluate whether intraoperative indocyanine green fluorescence angiography (ICG-FA) reduces the rate of anastomotic leakage (AL) in patients undergoing laparoscopic sigmoid or rectal cancer resection.

Approach:

• Study Design: A prospective single-center study with a retrospective historical control group, analyzing patients undergoing laparoscopic sigmoid or rectal cancer resection.
• Participants: 113 patients were analyzed, with 34 in the ICG-FA group and 79 in the control group.
• Endpoints: Primary endpoint was AL within 30 days; secondary outcomes included anastomotic stricture, postoperative complications, reoperation rates, length of hospital stay, readmission, and mortality.

Key Findings:

• The AL rate was 14.7% in the ICG-FA group and 12.7% in the control group (p = 0.768), showing no significant difference.
• No anastomotic strictures were observed in the ICG-FA group, while strictures occurred in 11.4% of the control group (p = 0.050).
• Other postoperative outcomes were similar between groups.

Interpretation:

Intraoperative ICG-FA did not significantly reduce the rate of AL but was associated with a lower incidence of anastomotic strictures.

Limitations:

• The study was conducted at a single center, which may limit generalizability.
• The sample size may not be sufficient to detect smaller differences in outcomes.

Conclusion:

Intraoperative ICG-FA did not significantly reduce the rate of AL but was associated with a lower incidence of anastomotic strictures.

Sources:

• Clinical Trials Registration