Indocyanine green angiography for lower incidence of anastomotic leakage after transanal total mesorectal excision: a propensity score-matched cohort study
BackgroundAnastomotic leakage (AL) is the most serious complication that can arise during colorectal surgery. Indocyanine green (ICG) angiography offers an intraoperative assessment of colonic vascular perfusion in real time. We aimed to assess ICG’s effects on the AL rate in patients who have under...
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1134723/full |
| _version_ | 1827930382811529216 |
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| author | Hengkai Chen Hengkai Chen Linfang Ye Linfang Ye Linfang Ye Changyu Huang Yingjun Shi Fangzhou Lin Honghao Ye Yongjian Huang Yongjian Huang |
| author_facet | Hengkai Chen Hengkai Chen Linfang Ye Linfang Ye Linfang Ye Changyu Huang Yingjun Shi Fangzhou Lin Honghao Ye Yongjian Huang Yongjian Huang |
| author_sort | Hengkai Chen |
| collection | DOAJ |
| description | BackgroundAnastomotic leakage (AL) is the most serious complication that can arise during colorectal surgery. Indocyanine green (ICG) angiography offers an intraoperative assessment of colonic vascular perfusion in real time. We aimed to assess ICG’s effects on the AL rate in patients who have undergone transanal total mesorectal excision (TaTME) for rectal cancer.MethodsThis retrospective cohort study was conducted at our center from October 2018 to March 2022 to analyze the clinical data of patients with rectal cancer who have undergone TaTME after propensity score matching (PSM). The primary outcome was the proximal colonic transection line modification and clinical AL rate.ResultsA total of 143 patients in the non-ICG group and 143 patients in the ICG group were included after PSM. The proximal colonic transection line of seven patients in the non-ICG group was modified, while 18 were in the ICG group (4.9% vs. 12.5%, p = 0.023). Twenty-three patients (16.1%) in the non-ICG group and five patients (3.5%) in the ICG group were diagnosed with AL (p < 0.001). The ICG group had a less hospital readmission rate than the non-ICG group (0.7% vs. 7.7%, p = 0.003). The between-group differences in basic line and other outcomes were not significant.ConclusionsICG angiography is a safe and feasible method to help surgeons identify potentially poor colonic vascular perfusion and modify the proximal colonic transection line, resulting in a significant reduction in AL and hospital readmission rates. |
| first_indexed | 2024-03-13T06:35:50Z |
| format | Article |
| id | doaj.art-402ca19c3f914ef08f40276b90a21e67 |
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| language | English |
| last_indexed | 2024-03-13T06:35:50Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-402ca19c3f914ef08f40276b90a21e672023-06-09T05:15:56ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-06-011310.3389/fonc.2023.11347231134723Indocyanine green angiography for lower incidence of anastomotic leakage after transanal total mesorectal excision: a propensity score-matched cohort studyHengkai Chen0Hengkai Chen1Linfang Ye2Linfang Ye3Linfang Ye4Changyu Huang5Yingjun Shi6Fangzhou Lin7Honghao Ye8Yongjian Huang9Yongjian Huang10Department of Colorectal Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Colorectal Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Colorectal Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Colorectal Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaFujian Medical University, Fuzhou, ChinaFujian Medical University, Fuzhou, ChinaFuzhou University, Fuzhou, ChinaFuzhou University, Fuzhou, ChinaFuzhou University, Fuzhou, ChinaDepartment of Gastrointestinal Surgery 2 Section, the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaDepartment of Gastrointestinal Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, ChinaBackgroundAnastomotic leakage (AL) is the most serious complication that can arise during colorectal surgery. Indocyanine green (ICG) angiography offers an intraoperative assessment of colonic vascular perfusion in real time. We aimed to assess ICG’s effects on the AL rate in patients who have undergone transanal total mesorectal excision (TaTME) for rectal cancer.MethodsThis retrospective cohort study was conducted at our center from October 2018 to March 2022 to analyze the clinical data of patients with rectal cancer who have undergone TaTME after propensity score matching (PSM). The primary outcome was the proximal colonic transection line modification and clinical AL rate.ResultsA total of 143 patients in the non-ICG group and 143 patients in the ICG group were included after PSM. The proximal colonic transection line of seven patients in the non-ICG group was modified, while 18 were in the ICG group (4.9% vs. 12.5%, p = 0.023). Twenty-three patients (16.1%) in the non-ICG group and five patients (3.5%) in the ICG group were diagnosed with AL (p < 0.001). The ICG group had a less hospital readmission rate than the non-ICG group (0.7% vs. 7.7%, p = 0.003). The between-group differences in basic line and other outcomes were not significant.ConclusionsICG angiography is a safe and feasible method to help surgeons identify potentially poor colonic vascular perfusion and modify the proximal colonic transection line, resulting in a significant reduction in AL and hospital readmission rates.https://www.frontiersin.org/articles/10.3389/fonc.2023.1134723/fullindocyanine green angiographyanastomotic leakagetransanal total mesorectal excisioncolonic vascular perfusionrectal cancer |
| spellingShingle | Hengkai Chen Hengkai Chen Linfang Ye Linfang Ye Linfang Ye Changyu Huang Yingjun Shi Fangzhou Lin Honghao Ye Yongjian Huang Yongjian Huang Indocyanine green angiography for lower incidence of anastomotic leakage after transanal total mesorectal excision: a propensity score-matched cohort study Frontiers in Oncology indocyanine green angiography anastomotic leakage transanal total mesorectal excision colonic vascular perfusion rectal cancer |
| title | Indocyanine green angiography for lower incidence of anastomotic leakage after transanal total mesorectal excision: a propensity score-matched cohort study |
| title_full | Indocyanine green angiography for lower incidence of anastomotic leakage after transanal total mesorectal excision: a propensity score-matched cohort study |
| title_fullStr | Indocyanine green angiography for lower incidence of anastomotic leakage after transanal total mesorectal excision: a propensity score-matched cohort study |
| title_full_unstemmed | Indocyanine green angiography for lower incidence of anastomotic leakage after transanal total mesorectal excision: a propensity score-matched cohort study |
| title_short | Indocyanine green angiography for lower incidence of anastomotic leakage after transanal total mesorectal excision: a propensity score-matched cohort study |
| title_sort | indocyanine green angiography for lower incidence of anastomotic leakage after transanal total mesorectal excision a propensity score matched cohort study |
| topic | indocyanine green angiography anastomotic leakage transanal total mesorectal excision colonic vascular perfusion rectal cancer |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1134723/full |
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