Anastomotic leakage after intestinal resection is one of the most serious complications of surgical intervention for hollow viscus injury. Adequate vascular perfusion of the anastomotic site is essential to prevent anastomotic leakage. Near-infrared imaging using indocyanine green (NIR-ICG) is useful for the objective assessment of vascular perfusion. The aim of this study was to evaluate the association of NIR-ICG with intestinal and mesenteric injuries. This was a retrospective, single-center study of patients undergoing surgery for intestinal and mesenteric injuries. NIR-ICG was used to evaluate vascular perfusion.

Postoperative complications were assessed between NIR-ICG and non-NIR-ICG groups. The use of NIR-ICG was associated with a lower incidence of Clavien-Dindo grade ≥ III complications with a statistical tendency (p = 0.076). When limited to patients that underwent intestinal resection, the use of NIR-ICG was significantly associated with a lower risk of perioperative complications (p = 0.009). The use of NIR-ICG tended to associate with the lower incidence of postoperative complications after intestinal and mesenteric trauma surgery. NIR-ICG was associated with a significantly lower risk of complications in patients undergoing intestinal resection. The NIR-ICG procedure is simple and quick and is expected to be useful for intestinal and mesenteric trauma.

AL increases mortality, length of hospital stay, 30-day readmission, and postoperative infection. As a result, hospital costs increased by more than $25,000 in the United States and more than €50,000 in Europe when compared to low-cost ICG. Complications, not limited to AL, doubled the length of hospital stay, increased the average total cost by $25,000, and decreases total balance and turns negative, resulting in a large loss.  

The use of NIR-ICG tended to associate with the lower postoperative complications of intestinal and mesenteric trauma. In addition, the use of NIR-ICG was associated with lower complications with statistical significance after intestinal resection. The NIR-ICG procedure is simple and quick and is expected to be useful in intestinal and mesenteric trauma.

https://www.nature.com/articles/s41598-021-03361-1

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