Prevention of colorectal anastomotic leakage by using of intraoperative fluorescent angiography: prospective trial data

• Published in: Hirurgija (Moskva) no. 8. Vyp. 2; p. 47
• Main Authors: Alexeev, M V, Shelygin, Yu A, Rybakov, E G
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2018
• Subjects: Anastomosis, Surgical - adverse effects; Anastomotic Leak - diagnostic imaging; Anastomotic Leak - etiology; Anastomotic Leak - prevention & control; Colectomy; Colon, Sigmoid - blood supply; Colon, Sigmoid - diagnostic imaging; Colon, Sigmoid - surgery; Colorectal Neoplasms - diagnostic imaging; Colorectal Neoplasms - surgery; Coloring Agents; Fluorescein Angiography; Humans; Indocyanine Green; Intraoperative Period; Prospective Studies; Rectum - blood supply; Rectum - diagnostic imaging; Rectum - surgery; colorectal surgery; indocyanine green; anastomotic failure; fluorescent angiography
• DOI: 10.17116/hirurgia201808247
• ISSN: 0023-1207

To evaluate the effect of intraoperative fluorescent angiography on the incidence of colorectal anastomosis failure. Prospective, non-comparative study included 52 patients with rectal or sigmoid cancer who underwent surgery with stapled colorectal anastomosis. Intraoperative fluorescent angiography with indocyanine green was performed to determine colon perfusion. All patients underwent proctography with water-soluble contrast agent in 6-8 days after surgery in order to determine anastomotic leakage. Fluorescent angiography was followed by changed volume of proximal colectomy in 14 (27%) patients due to inadequate blood supply of intestinal wall at previous surgical level. Additionally, 1-5 cm of intestinal wall were excised. Postoperative anastomotic leakage occurred in 3 (5.8%) patients. Fluorescent angiography with indocyanine green is accompanied by reduced incidence of anastomotic failure in colorectal suregry.