In the present study, patients with colorectal anastomoses that were assessed with indocyanine green (ICG) fluorescence angiography (FA) were compared to patients who had only white light visual inspection of their anastomosis. The impact of change in surgical plan guided by ICG-FA on anastomotic leak (AL) rates was assessed.
Results from the study:
- Anastomotic leaks were roughly 55% LESS LIKELY when ICG was used than when it was not (OR 0.452; 95% CI 0.366-0.558)
- Complications were roughly 25% LESS LIKELY when ICG was used than when it was not (OR 0.747; 95% CI 0.592-0.943)
- 9.6% of the time, using ICG identified something of concern that caused the surgeon to alter their surgical plan – of those 9.6% were 173% MORE LIKELY (OR = 2.73) to develop an anastomotic leak. ICG correctly identified higher-risk patients.
Conclusion: Assessment of colorectal anastomoses with ICG-FA is likely to be associated with lower odds of anastomotic leak than is traditional white light assessment. Change in plan based on ICG-FA may be associated with identifying patients with higher risk of developing an AL.