Utility of indocyanine-green fluorescent imaging during robot-assisted sphincter-saving surgery on rectal cancer patients.
BACKGROUND
There have been few studies describing the use of indocyanine green (ICG) fluorescent imaging during robot-assisted (RA) sphincter-saving operations (SSOs) and assessing its potential role in reducing anastomotic leak (AL).


METHODS
A consecutive cohort of 436 rectal cancer patients who underwent curative RA SSOs were prospectively enrolled during 2010-2014, including 123 patients with ICG imaging (ICG+group) and 313 patients without ICG imaging (ICG-group).


RESULTS
ICG imaging appeared to be helpful in identifying competent perfusion of the bowel adjacent to the anastomosis in 13 patients (10.6%) who might be susceptible to bowel ischaemia, including restrictive mesocolon. AL was remarkably greater in the ICG-group compared with the ICG+group (5.4% vs 0.8%; p = 0.031).


CONCLUSIONS
ICG imaging during RA SSO provides accurate real-time knowledge of the perfusion status at or near the anastomosis, specifically reducing AL in patients who may incur bowel ischaemia. Copyright © 2015 John Wiley & Sons, Ltd.
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Centre, Seoul, Korea.
Jin C
JC
Kim
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Centre, Seoul, Korea.
Jong L
JL
Lee
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Centre, Seoul, Korea.
Yong S
YS
Yoon
Department of Surgery, University of Ulsan College of Medicine and Asan Medical Centre, Seoul, Korea.
Abdulrahman M
AM
Alotaibi
Department of Pathology, University of Ulsan College of Medicine and Asan Medical Centre, Seoul, Korea.
Jihun
J
Kim
D000368:Aged; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical; D003952:Diagnostic Imaging; D005260:Female; D005456:Fluorescent Dyes / Q000737:chemistry; D006801:Humans; D007208:Indocyanine Green / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D011184:Postoperative Period; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000379:methods*; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome
D005456:Fluorescent Dyes; D007208:Indocyanine Green
fluorescence; indocyanine green; rectal cancer; robot-assisted; sphincter-saving operation