SynthesisSurgical endoscopy2020
Intraoperative use of fluorescence with indocyanine green reduces anastomotic leak rates in rectal cancer surgery: an individual participant data analysis.
Synthesis in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 8 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
42 citing papers in PubMed, 8 syntheses or guidelines pooled it, 77 citations in OpenAlex.
- Indocyanine green fluorescence angiography in mechanical bowel obstruction: impact on intraoperative decision-making and clinical guidance-a systematic review.Surgical endoscopy · 2026Pooled it
- Pooled it
- The role of indocyanine green fluorescence angiography in the perioperative period for patients after colorectal surgery: a meta-analysis of propensity score-matched studies with trial sequential analysis.Surgical endoscopy · 2025Pooled it
- Does indocyanine green fluorescence angiography reduce the risk of anastomotic leaks in colorectal resections? A systematic review and meta-analysis of randomized controlled trials.Updates in surgery · 2025Pooled it
- Fluorescence imaging in reducing anastomotic leak after left-sided colorectal resections: a systematic review and updated meta-analysis.ANZ journal of surgery · 2024Pooled it
- European Association for Endoscopic Surgery (EAES) consensus on Indocyanine Green (ICG) fluorescence-guided surgery.Surgical endoscopy · 2023Pooled 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
- Optimizing quantitative fluorescence angiography for visceral perfusion assessment.Surgical endoscopy · 2020Pooled it
- Clinical Burden of Anastomotic Leak After Elective Colorectal Cancer Surgery: A Multicenter Cohort Study.Journal of clinical medicine · 2026Article
- Decreased fluorescence latency and plateau intensity ratio as predictive markers of intraoperative hypoperfusion: quantitative indocyanine green perfusion analysis in colorectal cancer surgery.Annals of coloproctology · 2026Article
- Indocyanine green in intestinal endometriosis surgery: a multicenter evaluation of anastomotic safety.Journal of robotic surgery · 2026Observational
- Feasibility of Simultaneous Artificial Intelligence-Assisted and NIR Fluorescence Navigation for Anatomical Recognition in Laparoscopic Colorectal Surgery.Journal of fluorescence · 2025Article
- Risk Factors for Anastomotic Leakage: A Comprehensive Single-Center Analysis of Colorectal Anastomoses for Ovarian and Gastrointestinal Cancers.Annals of surgical oncology · 2025Article
- Indocyanine green fluorescence-guided surgery in the emergency setting: the WSES international consensus position paper.World journal of emergency surgery : WJES · 2025Article
- Fluorescence-guided tumor visualization of colorectal cancer using tumor-initiating probe yellow in preclinical models.Scientific reports · 2024Article
- Review
- Colorectal cancer: Recent advances in management and treatment.World journal of clinical oncology · 2024Review
- Diagnostic laparoscopy with indocyanine green fluorescence test for the evaluation of intestinal perfusion in abdominal blunt injury: a case report.International journal of emergency medicine · 2024Article
- Peritoneal fluid indocyanine green test for diagnosis of gut leakage in anastomotic leakage rats and colorectal surgery patients.World journal of gastrointestinal surgery · 2024Article
- Indocyanine green: The guide to safer and more effective surgery.World journal of gastrointestinal surgery · 2024Article
Corrections and comments
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Authors and funding
24 authors at 14 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFluorescence imaging by means of Indocyanine green (ICG) has been applied to intraoperatively determine the perfusion of the anastomosis. The purpose of this Individual Participant Database meta-analysis was to assess the effectiveness in decreasing the incidence of anastomotic leak (AL) after rectal cancer surgery.
methodsWe searched PubMed, Embase, Cochrane Library and ClinicalTrial.gov, EU Clinical Trials and ISRCTN registries on September 1st, 2019. We considered eligible those studies comparing the assessment of anastomotic perfusion during rectal cancer surgery by intraoperative use of ICG fluorescence compared with standard practice. We defined as primary outcome the incidence of AL at 30 days after surgery. The studies were assessed for quality by means of the ROBINS-I and the Cochrane risk tools. We calculated odds ratios (ORs) using the Individual patient data analysis, restricted to rectal lesions, according to original treatment allocation.
resultsThe review of the literature and international registries produced 15 published studies and 5 ongoing trials, for 9 of which the authors accepted to share individual participant data. 314 patients from two randomized trials, 452 from three prospective series and 564 from 4 non-randomized studies were included. Fluorescence imaging significantly reduced the incidence of AL (OR 0.341; 95% CI 0.220-0.530; p < 0.001), independent of age, gender, BMI, tumour and anastomotic distance from the anal verge and neoadjuvant therapy. Also, overall morbidity and reintervention rate were positively influenced by the use of ICG.
conclusionsThe incidence of AL may be reduced when ICG fluorescence imaging is used to assess the perfusion of a colorectal anastomosis. Limitations relate to the consistent number of non-randomized studies included and their heterogeneity in defining and assessing AL. Ongoing large randomized studies will help to determine the exact role of routine ICG fluorescence imaging may decrease the incidence of AL in surgery for rectal cancer.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.