Quantitative assessment of tissue perfusion in colorectal surgery using ICG fluorescence: first experience

Evaluation of the clinical efficacy of intraoperative quantitative fluorescence angiography using indocyanine green (ICG) for assessing intestinal wall perfusion to reduce the rate of colorectal anastomotic leakage. A prospective single-center comparative study was conducted, including 81 patients who underwent colon resection with anastomosis. In 42 patients, ICG fluorescence with real-time quantitative perfusion assessment was used. The control group (n = 39) underwent conventional visual assessment of tissue viability. The primary endpoint was the rate of anastomotic leakage; secondary endpoints included the rate of resection line modification and postoperative complications. In the ICG group, the anastomotic leakage rate was 4.8 % compared to 7.7 % in the control group (p = 0.664). Resection line modification based on fluorescence data was required in 14.8 % of patients. The relative risk of anastomotic leakage in the ICG group was 0.62 (95 % CI: 0.12–3.18), indicating a trend toward reduced complications that did not reach statistical significance. Intraoperative ICG fluorescence angiography demonstrates potential clinical benefits in perfusion assessment and resection level modification but did not show a significant reduction in anastomotic leakage rates. The method requires further investigation and standardization of quantitative data interpretation.

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