Abstract | BACKGROUND: Since the introduction of indocyanine green angiography more than 25 years ago, few studies have presented interpretative guidelines for indocyanine green fluorescent imaging. OBJECTIVE: We aimed to provide interpretative guidelines for indocyanine green fluorescent imaging through quantitative analysis and to suggest possible indications for indocyanine green fluorescent imaging during robot-assisted sphincter-saving operations. DESIGN: This is a retrospective observational study. SETTINGS: This study was conducted at a single center. PATIENTS: MAIN OUTCOME MEASURES: We tried to quantitatively define the indocyanine green fluorescent imaging findings based on perfusion (mesocolic and colic) time and perfusion intensity (5 grades) to provide probable indications. RESULTS: The anastomotic leakage rate was significantly lower in the indocyanine green fluorescent imaging+ group than in the indocyanine green fluorescent imaging- group (0.6% vs 5.2%) (OR, 0.123; 95% CI, 0.028-0.544; p = 0.006). Anastomotic stricture was closely correlated with anastomotic leakage (p = 0.002) and a short descending mesocolon (p = 0.003). Delayed perfusion (>60 s) and low perfusion intensity (1-2) were more frequently detected in patients with anastomotic stricture and marginal artery defects than in those without these factors (p ≤ 0.001). In addition, perfusion times greater than the mean were more frequently observed in patients aged >58 years, whereas low perfusion intensity was seen more in patients with short descending mesocolon and high ASA classes (≥3). LIMITATIONS: CONCLUSIONS: Quantitative analysis of indocyanine green fluorescent imaging may help prevent anastomotic complications during robot-assisted sphincter-saving operations, and may be of particular value in high-class ASA patients, older patients, and patients with a short descending mesocolon.
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Authors | Jin Cheon Kim, Jong Lyul Lee, Seong Ho Park |
Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 60
Issue 4
Pg. 376-384
(Apr 2017)
ISSN: 1530-0358 [Electronic] United States |
PMID | 28267004
(Publication Type: Journal Article, Observational Study)
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Chemical References |
- Coloring Agents
- Indocyanine Green
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Topics |
- Aged
- Anal Canal
- Anastomosis, Surgical
(methods)
- Anastomotic Leak
(epidemiology)
- Case-Control Studies
- Coloring Agents
- Digestive System Surgical Procedures
(methods)
- Female
- Humans
- Indocyanine Green
- Intraoperative Care
(methods)
- Male
- Middle Aged
- Optical Imaging
- Organ Sparing Treatments
(methods)
- Practice Guidelines as Topic
- Rectal Neoplasms
(diagnostic imaging, surgery)
- Rectum
(surgery)
- Retrospective Studies
- Robotic Surgical Procedures
(methods)
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