Indocyanine Green (ICG) Fluorescence in the Assessment of Vascularity of Anastomotic Margins in Colorectal Surgery in a Lower Middle-Income Country (LMIC) Hospital

Authors

  • Michael Geoffrey L. Lim, MD Division of Colorectal Surgery, Department of Surgery, Philippine General Hospital, University of the Philippines Manila https://orcid.org/0000-0002-1086-9573
  • Marc Paul J. Lopez, MD Division of Colorectal Surgery, Department of Surgery, Philippine General Hospital, University of the Philippines Manila
  • Mark Augustine S. Onglao, MD Division of Colorectal Surgery, Department of Surgery, Philippine General Hospital, University of the Philippines Manila
  • Marie Dione P. Sacdalan, MD Division of Colorectal Surgery, Department of Surgery, Philippine General Hospital, University of the Philippines Manila
  • Hermogenes J. Monroy, III, MD Division of Colorectal Surgery, Department of Surgery, Philippine General Hospital, University of the Philippines Manila

DOI:

https://doi.org/10.47895/amp.v58i16.7057

Keywords:

indocyanine green, colon, rectum, colorectal surgery, surgical anastomosis, anastomotic leak

Abstract

Background and Objective. One of the uses of indocyanine green (ICG) in the surgical field is the evaluation of the anastomotic margins in colorectal surgery. This is of particular importance because fluorescence imaging may aid in detecting vascular compromise, allowing the surgeon to change the resection margin thereby decreasing the chance of an anastomotic leak. To date, there has been no study with its use locally. This study aimed to determine whether the use of ICG can safely identify if the margins of resection are well-vascularized in patients undergoing left-sided colon or rectal surgery, which in turn may reduce anastomotic leak rates.

Methods. Through a retrospective study design, the investigators gathered data of patients who underwent left-sided colon or rectal surgery. The groups were divided into those with and without the use of ICG and a comparative data on the anastomotic leak rates were analyzed.

Results. Eighty-six (86) patients with similar patient characteristics, tumor staging, and surgical approach were compared. Both the leak rates identified during the initial hospital stay and at 30 days post-operatively were lower in those where ICG was used (p=0.035, p=0.047, respectively) than those where ICG was not used.

Conclusion. ICG fluorescence imaging may reduce the anastomotic leak rates in patients undergoing colorectal surgery.

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Published

2024-09-13

How to Cite

1.
Indocyanine Green (ICG) Fluorescence in the Assessment of Vascularity of Anastomotic Margins in Colorectal Surgery in a Lower Middle-Income Country (LMIC) Hospital. Acta Med Philipp [Internet]. 2024 Sep. 13 [cited 2025 Apr. 4];58(16). Available from: https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/7057

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