Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients
Despite the technological advances and improved surgical skills, the incidence of anastomotic leakage following colorectal cancer surgery still ranges from 4% to 19%. Therefore, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of indocyanine green (ICG) use in c...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/4/1036 |
| _version_ | 1797482055700840448 |
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| author | Kamil Safiejko Radoslaw Tarkowski Tomasz Piotr Kozlowski Maciej Koselak Marcin Jachimiuk Aleksander Tarasik Michal Pruc Jacek Smereka Lukasz Szarpak |
| author_facet | Kamil Safiejko Radoslaw Tarkowski Tomasz Piotr Kozlowski Maciej Koselak Marcin Jachimiuk Aleksander Tarasik Michal Pruc Jacek Smereka Lukasz Szarpak |
| author_sort | Kamil Safiejko |
| collection | DOAJ |
| description | Despite the technological advances and improved surgical skills, the incidence of anastomotic leakage following colorectal cancer surgery still ranges from 4% to 19%. Therefore, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of indocyanine green (ICG) use in colorectal cancer surgery. An online search of the Embase, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases (from inception to 10 November 2021) was performed, in addition to manual screening. Thirty-two studies involving 11,047 patients were considered eligible for the meta-analysis. The anastomotic leak rate in the ICG and non-ICG groups varied and amounted to 3.7% vs. 7.6%, respectively (RR = 0.46; 95% CI: 0.39–0.56; <i>p</i> < 0.001). The rate in randomized controlled trials (RCTs) was 8.1% in the ICG group compared with 12.1% in the non-ICG group (RR = 0.67; 95% CI: 0.46–0.98; <i>p</i> = 0.04). In non-RCTs, it equaled 3.1% vs. 7.3%, respectively (RR = 0.43; 95% CI: 0.35–0.52; <i>p</i> < 0.001). Although the publications encompassed in our meta-analysis present different patients, with different factors influencing the results, a pooled analysis revealed a lower incidence of anastomotic leak in cases with ICG use. There are several other convincing advantages: safety, simplicity, and short time of the method adjustment. The presented meta-analysis indicates ICG perfusion assessment as a tool worth considering to decrease the rate of complications following colorectal surgery—valuable in the context of other, well-known risk factors. |
| first_indexed | 2024-03-09T22:22:50Z |
| format | Article |
| id | doaj.art-1ef7135730e14e2984606731e9fa81c3 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T22:22:50Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-1ef7135730e14e2984606731e9fa81c32023-11-23T19:10:24ZengMDPI AGCancers2072-66942022-02-01144103610.3390/cancers14041036Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 PatientsKamil Safiejko0Radoslaw Tarkowski1Tomasz Piotr Kozlowski2Maciej Koselak3Marcin Jachimiuk4Aleksander Tarasik5Michal Pruc6Jacek Smereka7Lukasz Szarpak8Colorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, PolandDepartment of Surgical Oncology, Regional Specialist Hospital, 55-220 Legnica, PolandColorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, PolandInstitute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, PolandColorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, PolandColorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, PolandResearch Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, PolandResearch Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, PolandColorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, PolandDespite the technological advances and improved surgical skills, the incidence of anastomotic leakage following colorectal cancer surgery still ranges from 4% to 19%. Therefore, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of indocyanine green (ICG) use in colorectal cancer surgery. An online search of the Embase, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases (from inception to 10 November 2021) was performed, in addition to manual screening. Thirty-two studies involving 11,047 patients were considered eligible for the meta-analysis. The anastomotic leak rate in the ICG and non-ICG groups varied and amounted to 3.7% vs. 7.6%, respectively (RR = 0.46; 95% CI: 0.39–0.56; <i>p</i> < 0.001). The rate in randomized controlled trials (RCTs) was 8.1% in the ICG group compared with 12.1% in the non-ICG group (RR = 0.67; 95% CI: 0.46–0.98; <i>p</i> = 0.04). In non-RCTs, it equaled 3.1% vs. 7.3%, respectively (RR = 0.43; 95% CI: 0.35–0.52; <i>p</i> < 0.001). Although the publications encompassed in our meta-analysis present different patients, with different factors influencing the results, a pooled analysis revealed a lower incidence of anastomotic leak in cases with ICG use. There are several other convincing advantages: safety, simplicity, and short time of the method adjustment. The presented meta-analysis indicates ICG perfusion assessment as a tool worth considering to decrease the rate of complications following colorectal surgery—valuable in the context of other, well-known risk factors.https://www.mdpi.com/2072-6694/14/4/1036indocyanine green (ICG)fluorescenceanastomotic leakcolorectal anastomosessystematic reviewmeta-analysis |
| spellingShingle | Kamil Safiejko Radoslaw Tarkowski Tomasz Piotr Kozlowski Maciej Koselak Marcin Jachimiuk Aleksander Tarasik Michal Pruc Jacek Smereka Lukasz Szarpak Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients Cancers indocyanine green (ICG) fluorescence anastomotic leak colorectal anastomoses systematic review meta-analysis |
| title | Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients |
| title_full | Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients |
| title_fullStr | Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients |
| title_full_unstemmed | Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients |
| title_short | Safety and Efficacy of Indocyanine Green in Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis of 11,047 Patients |
| title_sort | safety and efficacy of indocyanine green in colorectal cancer surgery a systematic review and meta analysis of 11 047 patients |
| topic | indocyanine green (ICG) fluorescence anastomotic leak colorectal anastomoses systematic review meta-analysis |
| url | https://www.mdpi.com/2072-6694/14/4/1036 |
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