Indocyanine green fluorescent imaging on anastomotic leakage in colectomies: a network meta-analysis and systematic review.

Abstract:

PURPOSE:The usage of indocyanine green (ICG) dye is commonly associated with decreased anastomotic leakage rates in colectomies. This study aims to perform a network meta-analysis to assess the usage of ICG fluorescence imaging in right-sided colectomies. METHODS:Medline, Embase, Cochrane Trials, CNKI, and WanFang electronic databases were reviewed, and meta-analysis of proportions, comparative meta-analysis, and network meta-analysis were conducted in this review. Studies comparing ICG usage with conventional approaches of anastomosis were selected, with postoperative anastomotic leak rate being the primary outcome. RESULTS:Ten articles were included, with a total of 675 patients involved, of which 515 patients underwent colorectal surgery with ICG. Anastomotic leak rates with ICG were estimated to be 1% (CI 0.00-0.04) and 3% (CI 0.01-0.06) for right and left procedures, respectively. No significant difference was observed in left-sided colectomies (OR 0.587; 95% CI 0.218-1.582; p = 0.292). There were nearly half the odds of anastomotic leakage when ICG was used in right-sided colectomies (OR 0.524; 95% CI 0.128-2.137). CONCLUSION:With the ability to potentially avert postoperative anastomotic leakage, coupled with its minimal costs and side effects, administration of ICG in colectomies in centers where equipment is available should be encouraged.

journal_name

Int J Colorectal Dis

authors

Mok HT,Ong ZH,Yaow CYL,Ng CH,Buan BJL,Wong NW,Chong CS

doi

10.1007/s00384-020-03723-7

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

2365-2369

issue

12

eissn

0179-1958

issn

1432-1262

pii

10.1007/s00384-020-03723-7

journal_volume

35

pub_type

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