A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal Surgery
Anastomotic leakage is one of the most dreaded complications of colorectal surgery and is strongly associated with tissue perfusion. Indocyanine green fluorescence angiography (ICG-FA) using indocyanine green and near-infrared systems is an innovative technique that allows the visualization of anast...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/22/5623 |
| _version_ | 1797465702393708544 |
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| author | Masayoshi Iwamoto Kazuki Ueda Junichiro Kawamura |
| author_facet | Masayoshi Iwamoto Kazuki Ueda Junichiro Kawamura |
| author_sort | Masayoshi Iwamoto |
| collection | DOAJ |
| description | Anastomotic leakage is one of the most dreaded complications of colorectal surgery and is strongly associated with tissue perfusion. Indocyanine green fluorescence angiography (ICG-FA) using indocyanine green and near-infrared systems is an innovative technique that allows the visualization of anastomotic perfusion. Based on this information on tissue perfusion status, surgeons will be able to clearly identify colorectal segments with good blood flow for safer colorectal anastomosis. The results of several clinical trials indicate that ICG-FA may reduce the risk of AL in colorectal resection; however, the level of evidence is not high, as several other studies have failed to demonstrate a reduction in the risk of AL. Several large-scale RCTs are currently underway, and their results will determine whether ICG-FA is, indeed, useful. The major limitation of the current ICG-FA evaluation method, however, is that it is subjective and based on visual assessment by the surgeon. To complement this, the utility of objective evaluation methods for fluorescence using quantitative parameters is being investigated. Promising results have been reported from several clinical trials, but all trials are preliminary owing to their small sample size and lack of standardized protocols for quantitative evaluation. Therefore, appropriately standardized, high-quality, large-scale studies are warranted. |
| first_indexed | 2024-03-09T18:26:14Z |
| format | Article |
| id | doaj.art-48a64b21445840d3bf5537c83e050bbc |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T18:26:14Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-48a64b21445840d3bf5537c83e050bbc2023-11-24T07:54:07ZengMDPI AGCancers2072-66942022-11-011422562310.3390/cancers14225623A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal SurgeryMasayoshi Iwamoto0Kazuki Ueda1Junichiro Kawamura2Department of Surgery, Faculty of Medicine, Kindai University, 377-2, Ohnohigashi, Osaka Sayama 589-8511, JapanDepartment of Surgery, Faculty of Medicine, Kindai University, 377-2, Ohnohigashi, Osaka Sayama 589-8511, JapanDepartment of Surgery, Faculty of Medicine, Kindai University, 377-2, Ohnohigashi, Osaka Sayama 589-8511, JapanAnastomotic leakage is one of the most dreaded complications of colorectal surgery and is strongly associated with tissue perfusion. Indocyanine green fluorescence angiography (ICG-FA) using indocyanine green and near-infrared systems is an innovative technique that allows the visualization of anastomotic perfusion. Based on this information on tissue perfusion status, surgeons will be able to clearly identify colorectal segments with good blood flow for safer colorectal anastomosis. The results of several clinical trials indicate that ICG-FA may reduce the risk of AL in colorectal resection; however, the level of evidence is not high, as several other studies have failed to demonstrate a reduction in the risk of AL. Several large-scale RCTs are currently underway, and their results will determine whether ICG-FA is, indeed, useful. The major limitation of the current ICG-FA evaluation method, however, is that it is subjective and based on visual assessment by the surgeon. To complement this, the utility of objective evaluation methods for fluorescence using quantitative parameters is being investigated. Promising results have been reported from several clinical trials, but all trials are preliminary owing to their small sample size and lack of standardized protocols for quantitative evaluation. Therefore, appropriately standardized, high-quality, large-scale studies are warranted.https://www.mdpi.com/2072-6694/14/22/5623colorectal surgeryindocyanine greennear-infraredfluorescence imagingfluorescence angiographyperfusion |
| spellingShingle | Masayoshi Iwamoto Kazuki Ueda Junichiro Kawamura A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal Surgery Cancers colorectal surgery indocyanine green near-infrared fluorescence imaging fluorescence angiography perfusion |
| title | A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal Surgery |
| title_full | A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal Surgery |
| title_fullStr | A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal Surgery |
| title_full_unstemmed | A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal Surgery |
| title_short | A Narrative Review of the Usefulness of Indocyanine Green Fluorescence Angiography for Perfusion Assessment in Colorectal Surgery |
| title_sort | narrative review of the usefulness of indocyanine green fluorescence angiography for perfusion assessment in colorectal surgery |
| topic | colorectal surgery indocyanine green near-infrared fluorescence imaging fluorescence angiography perfusion |
| url | https://www.mdpi.com/2072-6694/14/22/5623 |
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