Abstract | PURPOSE: METHODS: This was a retrospective, single-center cohort study conducted on 852 consecutive patients who underwent laparoscopic sphincter-sparing surgery from January 2007 to June 2017 at our institution. The incidence of anastomotic leakage was compared between patients who underwent ICG-FA to determine the proximal resection margin and those in whom this technique was not performed, using logistic regression analysis, including propensity score. RESULTS: A total of eight patients were excluded (one patient with previous low anterior resection and seven patients who underwent simultaneous resection for other primary cancers), resulting in 844 patients being analyzed. Before propensity score matching, 141 patients (16.7%) who underwent ICG-FA were compared with 703 patients (83.3%) in whom ICG-FA was not performed. The incidence of anastomotic leakage was 2.8% (4/141) in the ICG-FA group and 12.4% (87/703) in the control group (p = 0.001). After propensity score matching (n = 420), the patient characteristics between the two groups were well balanced, and the incidence of anastomotic leakage was 2.8% (4/141) in the ICG-FA group and 13.6% (38/279) in the control group (p = 0.001). Logistic regression analyses using propensity score showed that patients who underwent ICG-FA had significantly lower odds of anastomotic leakage. CONCLUSION: Intraoperative ICG-FA is a promising method to reduce anastomotic leakage after laparoscopic rectal surgery.
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Authors | Hiro Hasegawa, Yuichiro Tsukada, Masashi Wakabayashi, Shogo Nomura, Takeshi Sasaki, Yuji Nishizawa, Koji Ikeda, Tetsuo Akimoto, Masaaki Ito |
Journal | International journal of colorectal disease
(Int J Colorectal Dis)
Vol. 35
Issue 3
Pg. 471-480
(Mar 2020)
ISSN: 1432-1262 [Electronic] Germany |
PMID | 31907595
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Aged
- Anal Canal
(surgery)
- Anastomotic Leak
(diagnostic imaging, etiology)
- Cohort Studies
- Female
- Fluorescein Angiography
- Humans
- Indocyanine Green
(chemistry)
- Intraoperative Care
- Laparoscopy
(adverse effects)
- Logistic Models
- Male
- Middle Aged
- Organ Sparing Treatments
- Perfusion
- Rectal Neoplasms
(surgery)
- Treatment Outcome
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