{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T11:46:07Z","timestamp":1793274367573,"version":"4.5.0"},"reference-count":88,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001631","name":"University College Dublin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001631","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Indocyanine green fluorescence angiography (ICGFA) during colorectal surgery either reassures surgeons regarding intestinal perfusion sufficiency or prompts changed surgical strategy by indicating unsuspected insufficiency. This study describes existing evidence supporting ICGFA use in colorectal surgery, particularly regarding impact on intraoperative decisions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Searches were performed on PubMed, ScienceDirect, Scopus, Web of Science, Cochrane Collaboration databases on 5th December 2023, updated to 19th August 2024. Full English language publications of clinical studies in human patients undergoing colorectal resection with primary anastomosis with the use of ICGFA to assess bowel perfusion intraoperatively, with a control group, were included. Pooling of anastomotic leak (AL) rates was performed for primary outcome analysis with odds ratio (OR) and number-needed-to-treat (NNT) calculated regarding leak reduction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>45 studies comprising 14,333 patients were included, with 7 randomised controlled trials (2911 patients). Overall, AL rate was 6.8%, 4.5% with ICGFA and 8.5% without (OR:0.47, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, NNT 23), increasing to 9.5%, 7.5% and 11.6%, respectively, in randomised controlled trials (OR:0.62, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01, NNT 25). In rectal resections, AL rate was 4.7% with ICGFA vs 11.5% without (OR: 0.38, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). 26 studies performed ICGFA before and after anastomosis formation and 19 used ICGFA only prior to bowel transection, with no significant difference of AL rate reduction on subgroup testing. ICGFA prompted a change in surgical plan in 8.4% of thirty-four studies reporting this. Interestingly, in these studies, leak rates overall were 3.7% when ICGFA matched surgeon judgement versus 5.7% when it prompted change (OR 0.51, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0025), versus 7.7% without (OR 0.45, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). In rectal resections, these figures were 5%, 8.8% (OR 0.42, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and 12.0% (OR0.39, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>ICGFA colorectal perfusion assessment is associated with lower anastomotic leak rates, especially when confirming surgeons\u2019 judgement, and may so stratify patients post-operatively regarding subsequent anastomotic leak rate.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-11582-y","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T18:18:01Z","timestamp":1738606681000},"page":"1473-1489","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Impact of indocyanine green fluorescence angiography on surgeon action and anastomotic leak in colorectal resections. 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Ashokkumar Singaravelu has no conflicts of interest or financial ties to disclose. Patrick A Boland\u2019s role as a research fellow is funded by the Horizon Europe CLASSICA study and the European Union. Alice Moynihan has no conflicts of interest or financial ties to disclose. Ben Creavin has no conflicts of interest or financial ties to disclose. Ronan A Cahill is named on a patent filed in relation to processes for visual determination of tissue biology, receives speaker fees from Stryker Corp and Ethicon\/J&J, consultancy fees from Arthrex, Astellas, Diagnostic Green and Touch Surgery (Medtronic), research funding from Intuitive Corp and Medtronic as well as recently from the Irish Government (DTIF) in collaboration with IBM Research in Ireland, and from EU Horizon 2020 in collaboration with Palliare and, currently, from Horizon Europe in collaboration with Arctur.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}