Indocyanine green fluorescence angiography for anastomotic perfusion assessment in colorectal surgery: a systematic review with meta-analysis, meta-regression, and trial sequential analyses - PubMed
4 hours ago
- #anastomotic leak
- #colorectal surgery
- #ICGFA
- Indocyanine green fluorescence angiography (ICGFA) significantly reduces anastomotic leak rates in colorectal surgery.
- ICGFA showed significant benefits for left-sided, rectal, and low anterior resections, but not for right-sided resections.
- The meta-analysis included nine RCTs with 4754 patients, showing a risk ratio of 0.66 for overall anastomotic leak reduction.
- Patient BMI was the only covariate that significantly modified the ICGFA treatment effect, with increasing protective effect as BMI increased.
- Evidence was graded as high certainty for overall, left-sided, rectal, asymptomatic, and 30-day anastomotic leaks.
- The study suggests that further general efficacy trials are unnecessary, and research should focus on implementation and subgroup role definition.