Introduction: Colorectal cancer is one of the most common gastrointestinal tumors. Anastomotic leakage (AL) after low rectal resections remains a serious problem worldwide, varying between 5% and 20%. The main risk factors for AL are the height of the anastomosis, gender, non-adjuvant therapy, difficult mesorectal excision, advanced age, nutritional status of the patient, as well as the chronic use of certain medications. The concept of intraoperative indocyaninegreen (ICG) angiography is based on its ability to absorb near-infrared (NIR) light up to 800 nm and emit fluorescence at a wavelength of 830 nm. Bolus of ICG is injected into the patient intravenously. After a period of time, NIR light is absorbed by the ICG in the tissues and the resulting fluorescence is a reflection of tissue perfusion.
Aim: The aim of study is to evaluate the efficancy of ICG in colorectal surgery.
Materials and Methods: We conducted a retrospective study, with all robotic colorectal resections for the last year, with and without ICG, for perfusion assessement before and after the construction of the anastomosis, as well as the last 48 colorectal cases without the use of ICG.
In our patients, we did not observe significant differences in the operative time (201.6 ± 87.5 min in the ICG and 204.9 ± 76.1 in the group without, 95% CI: −12.42 to 10.87; p = 0.87), the intraoperative blood loss (100 ± 78. mL in ICG group and 98 ± 68 mL in the other; 95% CI: −16.43 to 7.35; p = 0.42), and in the need for blood transfusion in both groups (95% CI: 0.37–2.72; p = 1.10). The incidence of AL in the ICG and non-ICG group was 1/16.6.2% vs. 4/48,8.3%, (95% CI: 0.39–0.56; p < 0.). In the hospital stay, we did not observe a significant difference in the two groups. It was 6.7 ± 5.2 days in the group with ICG and 6.5 ± 5.1 in the group without (95% CI: −0.84 to 0.05; p = 0.08).
Conclusion: The results of our study support the thesis of most authors about reducing the AL rate when using ICG. Larger multicenter studies are needed to confirm these data.
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