Compromised tissue perfusion is one of the few factors that can be influenced at the time of surgery to lower risk of Anastomotic Leakage. ICG Fluorescence Angiography has proven to be a feasible and reproducible application for perfusion assessment. Several cohort studies have shown that visualisation of bowel perfusion resulting in reduced leakage rates, especially in left sided colon resection and low anterior resection.1
The poor inter-observer agreement within Upper-GI underlines the need for quantification of ICG-FA2 Several randomised controlled trials started to investigate the benefit of intraoperative imaging with ICG for the reduction of Anastomotic Leakage.
1Meijer RPJ, Faber RA, Bijlstra OD, et al. AVOID; a phase III, randomised controlled trial using indocyanine green for the prevention of anastomotic leakage in colorectal surgery, BMJ Open. 2022; 12(4): e051144. Published online 2022 Apr 1. doi: 10.1136/bmjopen-2021-051144
PMCID: PMC8977759 PMID: 35365509 Protocol,
2Galema HA, Faber RA, Tange FP, et al. A quantitative assessment of perfusion of the gastric conduit after oesophagectomy using near-infrared fluorescence with indocyanine green: Eur J Surg Oncol. 2023 May;49(5):990-995. doi: 10.1016/j.ejso.2023.02.017. Epub 2023 Mar 2
