The efficacy of intraoperative ICG fluorescence angiography on anastomotic leak after resection for colorectal cancer: a
- PDF / 1,360,415 Bytes
- 13 Pages / 595.276 x 790.866 pts Page_size
- 70 Downloads / 230 Views
REVIEW
The efficacy of intraoperative ICG fluorescence angiography on anastomotic leak after resection for colorectal cancer: a meta-analysis Jiajing Lin 1 & Bingqiu Zheng 1 & Suyong Lin 1 & Zhihua Chen 1 & Shaoqin Chen 1 Accepted: 25 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objective The purpose of this study was to investigate whether intraoperative indocyanine green fluorescence angiography can reduce the incidence of anastomotic leak. Methods Present authors conducted a systematic search of PubMed, EMBASE, and Cochrane databases for randomized controlled trials (RCTs), prospective nonrandomized trials, and retrospective trials up to March 2020. Eleven papers fulfilling the screening criteria were included. Intervention Indocyanine green was injected intravenously after the division of the mesentery and colon but before anastomosis. The primary outcome measure was AL rate with at least 3 months of follow-up. Secondary outcome measure was operation time, postoperative complications, surgical site infection, reoperation, and ileus rate. The results were analyzed using STATA 12.0 software (Stata Corp, College Station, TX, USA). Result A total of 3137 patients were collected in 11 studies. Meta-analysis showed that compared with conventional surgery, the ICG fluorescence angiography resulted in a fewer AL rate (OR = 0.31; 95% CI 0.21 to 0.44; P < 0.0001), postoperative complications (OR = 0.70; 95% CI 0.51 to 0.96; P < 0.025), and reoperation rate (OR = 0.334; 95% CI 0.16 to 0.68; P = 0.003). Operation time (weighted mean difference − 25.162 min; 95% CI − 58.7 to 8.375; P = 0.141), surgical site infection rate (OR = 1.11; 95% CI 0.59 to 2.09; P = 0.742) did not differ between the two groups. Conclusion The result revealed that indocyanine green was associated with a lower anastomotic leakage rate after colorectal cancer resection. However, larger, multicentered, high-quality randomized controlled trials are needed to confirm the benefit of indocyanine green fluorescence angiography. Keywords Anastomotic leakage . Colorectal cancer . Fluorescence angiography . Indocyanine green
Introduction Colorectal cancer (CRC) is one of the most common cancers worldwide, with an annual incidence rate of 1.2 million and an annual mortality rate of over 600,000 individuals [1]. With increases in population size and density, the incidence rate of colorectal cancer is increasing year by year in the world. Although the science technology and surgical techniques have Jiajing Lin and Bingqiu Zheng contributed equally to this work. * Shaoqin Chen [email protected] 1
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Taijiang, Fuzhou, Fujian 350004, People’s Republic of China
advanced, several severe complications in colorectal cancer still exist. Anastomotic leakage (AL) continues to be the most difficult complication for colorectal cancer. The AL rate in colorectal surgery varies from 1 to 19% depending on the anatomic
Data Loading...
