Does indocyanine green fluorescence angiography reduce the risk of anastomotic leaks in colorectal resections?: A systematic review and meta-analysis of randomized controlled trials
Anastomotic leaks are a significant complication in colorectal surgery. Indocyanine green fluorescence angiography (ICG-FA) has been suggested as a method to reduce the risk. This meta-analysis aims to evaluate the effect of ICG-FA on reducing anastomotic leaks in colorectal surgery. This study foll...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2025
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| In: |
Updates in surgery
Year: 2025, Volume: 77, Pages: 83-95 |
| ISSN: | 2038-3312 |
| DOI: | 10.1007/s13304-024-02036-6 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s13304-024-02036-6
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| Author Notes: | Ahmed Elmajdub, Nahed Brebesh, Annis Maatough, Frank Willeke, Christel Weiss, Ibrahim Darwich |
| Summary: | Anastomotic leaks are a significant complication in colorectal surgery. Indocyanine green fluorescence angiography (ICG-FA) has been suggested as a method to reduce the risk. This meta-analysis aims to evaluate the effect of ICG-FA on reducing anastomotic leaks in colorectal surgery. This study follows PRISMA guidelines and is registered on PROSPERO (CRD42022370748). We conducted a comprehensive search of multiple databases and registers for randomized controlled trials (RCTs) comparing ICG-FA with standard methods in colorectal surgery. Data extraction and quality assessment were performed by two independent reviewers, with a third resolving disputes. Odds ratios (OR) and mean differences (MD) were calculated using comprehensive meta-analysis software, version 3. Heterogeneity and publication bias were assessed, and a sensitivity analysis was performed. The analysis included five RCTs with a total of 1369 patients from four countries. The ICG-FA was associated with a 45% reduction in the risk of overall anastomotic leaks (OR: 0.550, p = 0.012). Subgroup analysis showed a 47% reduction in leaks for low anastomoses (OR: 0.53, p = 0.143) and a 69% reduction in grade A leaks (OR: 0.31, p = 0.008). No significant effects were observed for grade B and C leaks, blood loss, surgery duration, hospital stay, mortality, postoperative ileus, reoperation, or surgical site infections. ICG-FA significantly reduces the overall risk of anastomotic leaks, especially grade A leaks, and shows a trend towards fewer leaks in low anastomosis. No significant impact was found on secondary outcomes. Further RCTs are needed to confirm these findings. |
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| Item Description: | Veröffentlicht: 02. Dezember 2024 Gesehen am 12.03.2025 |
| Physical Description: | Online Resource |
| ISSN: | 2038-3312 |
| DOI: | 10.1007/s13304-024-02036-6 |