ArticleSurgical endoscopy2021
The impact of fluorescence angiography on anastomotic leak rate following transanal total mesorectal excision for rectal cancer: a comparative study.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 12 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 12 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- SAGES 2025 systematic review and meta-analysis for fluorescence image-guided gastrointestinal surgery using indocyanine green.Surgical endoscopy · 2025Pooled it
- The use of indocyanine green for colorectal anastomoses: a systematic review and meta-analysis.Annals of the Royal College of Surgeons of England · 2025Pooled it
- Indocyanine green and height of anastomosis in colorectal surgery- a network meta-analysis.Langenbeck's archives of surgery · 2025Pooled it
- Impact of indocyanine green fluorescence angiography on surgeon action and anastomotic leak in colorectal resections. A systematic review and meta-analysis.Surgical endoscopy · 2025Pooled it
- The impact of indocyanine green fluorescence angiography (ICG-FA) on anastomotic leak rates and postoperative outcomes in colorectal anastomoses: a systematic review.Surgical endoscopy · 2025Pooled it
- Intraoperative bowel perfusion assessment methods and their effects on anastomotic leak rates: meta-analysis.The British journal of surgery · 2023Pooled it
- Intraluminal Anastomotic Assessment Using Indocyanine Green Near-Infrared Imaging for Left-Sided Colonic and Rectal Resections: a Systematic Review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Pooled it
- Indocyanine green fluorescence angiography decreases the risk of anastomotic leakage after rectal cancer surgery: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- Impact of change in the surgical plan based on indocyanine green fluorescence angiography on the rates of colorectal anastomotic leak: a systematic review and meta-analysis.Surgical endoscopy · 2022Pooled it
- Effect of Indocyanine Green Fluorescence Angiography on Anastomotic Leakage in Patients Undergoing Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials and Propensity-Score-Matched Studies.Frontiers in surgery · 2022Pooled it
- Effect of indocyanine green fluorescence angiography on preventing anastomotic leakage after colorectal surgery: a meta-analysis.Surgery today · 2021Pooled it
- Indocyanine green fluorescence angiography prevents anastomotic leakage in rectal cancer surgery: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2021Pooled it
- Multicenter phase II trial of transanal total mesorectal excision for rectal cancer: preliminary results.Surgical endoscopy · 2023Trial
- Intraoperative Multimodal Bowel Perfusion Quantification Combining Hyperspectral Imaging and Indocyanine Green.Diagnostics (Basel, Switzerland) · 2026Article
- Assessment of intra-operative bowel perfusion in children using indocyanine green: an exploratory study investigating its effect on surgical management.Pediatric surgery international · 2026Article
- Risk factors for anastomotic leakage in rectal cancer surgery reflecting current practices.Surgery today · 2025Article
- C-reactive protein-to-albumin ratio as a risk factor for anastomotic leakage after anterior resection for rectal cancer with intraoperative use of indocyanine green fluorescence imaging.Surgical endoscopy · 2024Article
- Fluorescent ICG angiography in laparoscopic rectal resection - a randomized controlled trial. Preliminary report.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2023Article
- A narrative review of intraoperative use of indocyanine green fluorescence imaging in gastrointestinal cancer: situation and future directions.Journal of gastrointestinal oncology · 2023Review
- Incidence and Risk Factors of Surgical Complications and Anastomotic Leakage After Transanal Total Mesorectal Excision for Middle and Low Rectal Cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnastomotic leak (AL) is the most feared complication in colorectal surgery. Indocyanine green (ICG) fluorescence angiography allows for real-time intraoperative evaluation of bowel perfusion. This study aimed to assess the impact of ICG on perioperative outcomes in patients treated with transanal total mesorectal excision (TaTME) for rectal cancer.
methodsComparative study based on a retrospective analysis of prospectively collected data, to validate the use of ICG assessment (ICGA) during TaTME (November/2011-June/2018). The primary outcome was the clinical AL rate. The secondary outcomes included modification of proximal colonic transection, anastomotic redo, additional surgical maneuvers and surgical morbidity.
resultsTwo hundred and eighty-four patients were included, 204 (71.8%) in non-ICG group and 80 (28.2%) in ICG group. No significant differences were found in patient and tumor features. Mean anastomotic height was 4.85 cm vs. 5.04 cm (p = 0.500), diverting stoma was constructed in 205 patients (72.1% vs. 72.5%; p = 0.941). Fluorescence angiography modified the surgical plan in 23 patients (28.7%). AL was diagnosed in 23 patients (11.3%) in the non-ICG group and in two patients (2.5%) in the ICG group (p = 0.020). Postoperative intraabdominal collection was diagnosed in 19 patients (7.4% vs. 5.1%; p = 0.490), and reintervention was needed in 24 patients (10.8% vs. 7.6%; p = 0.420). Median length of hospital stay was 6.0 (IQR 5.0-9) vs. 4.0 (IQR 3.0-8.5) (p = 0.005). ICGA was found as independent protective factor for AL in the multivariate analysis of the whole cohort (n = 284) (OR 0.142; 95% CI 0.032-0.633; p = 0.010).
conclusionICG fluorescence angiography modified the proximal colonic transection in more than one-quarter of patients, leading to a significant decrease of AL rate.
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