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Enhancing colorectal anastomotic safety with indocyanine green fluorescence angiography: An update.

Pampiglione, T; Chand, M; (2021) Enhancing colorectal anastomotic safety with indocyanine green fluorescence angiography: An update. Surgical Oncology , Article 101545. 10.1016/j.suronc.2021.101545. (In press).

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Abstract

Reducing anastomotic leak (AL) continues to be a main focus in colorectal research. Several new technologies have been developed with an aim to reduce this from mechanical devices to advanced imaging techniques. Fluorescence angiography (FA) with indocyanine green (ICG) in colorectal surgery is now a well-established technique and may have a role in reducing AL. By using FA, we are able to have a visual representation of perfusion which aids intraoperative decision making. The main impact is change in the level of bowel transection at the proximal side of an anastomosis and provide a more objective and confident assessment of bowel perfusion. Previous studies have shown that routine FA use is safe and reproducible. Recent results from randomized control trials and meta-analyses show that FA use reduces the rate of anastomotic leak. The main limitation of FA is its lack of ability to quantify perfusion. Novel technologies are being developed that will quantify tissue perfusion and oxygenation. Overall, FA is a safe and feasible technique which may have a role in reducing AL.

Type: Article
Title: Enhancing colorectal anastomotic safety with indocyanine green fluorescence angiography: An update.
Location: Netherlands
DOI: 10.1016/j.suronc.2021.101545
Publisher version: https://doi.org/10.1016/j.suronc.2021.101545
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
Keywords: Anastomotic leak, Colorectal surgery, Fluorescence angiography, Fluorescence imaging, Indocyanine green, Near infrared
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: https://discovery.ucl.ac.uk/id/eprint/10128890
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