{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T21:43:43Z","timestamp":1792187023778,"version":"4.4.0"},"reference-count":9,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anastomotic leakage (AL) remains a major postoperative complication after rectal cancer surgery, even with advances in minimally invasive techniques. Indocyanine green (ICG) fluorescence imaging is widely used to assess bowel perfusion, but conventional methods rely heavily on subjective visual interpretation. The SPY\u2010QP software enables quantitative evaluation of ICG fluorescence, potentially improving the accuracy of perfusion assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The SPECTACLE study is a multicenter, prospective, single\u2010arm trial designed to evaluate whether SPY\u2010QP\u2010based quantitative blood flow assessment can reduce AL rates compared with historical controls from the EssentiAL study. Perfusion assessment is performed according to an algorithm we developed based on our previous retrospective analysis. We plan to enroll 400 patients undergoing laparoscopic or robotic rectal cancer resection with anastomosis. The primary endpoint is the incidence of AL (Grades A\u2013C) within 30\u2009days postoperatively. Secondary endpoints include changes in surgical strategy based on perfusion findings, operative time, intraoperative complications, and other postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study aims to provide robust evidence on whether objective perfusion assessment using SPY\u2010QP can reduce AL after rectal cancer surgery, potentially leading to broader adoption of quantitative imaging in colorectal surgery.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Japan Registry of Clinical Trials: jRCTs032230212\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70209","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:14:04Z","timestamp":1766535244000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The\n                    <scp>SPECTACLE<\/scp>\n                    Study: A Multicenter, Prospective, Single\u2010Arm Trial Evaluating Quantitative Blood Flow Assessment Using\n                    <scp>SPY<\/scp>\n                    \u2010\n                    <scp>QP<\/scp>\n                    Software in Minimally Invasive Rectal Cancer Surgery"],"prefix":"10.1111","volume":"19","author":[{"given":"Atsushi","family":"Hamabe","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery The University of Osaka  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamoru","family":"Uemura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery The University of Osaka  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Suwa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastroenterological Center Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujiro","family":"Nishizawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Osaka General Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Kagawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kimura","sequence":"additional","affiliation":[{"name":"Division of Lower GI, Department of Gastroenterological Surgery Hyogo Medical University  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