Evidence map›Paper›PMID 39617825›Full record

SynthesisUpdates in surgery2025

Does indocyanine green fluorescence angiography reduce the risk of anastomotic leaks in colorectal resections? A systematic review and meta-analysis of randomized controlled trials.

Ahmed Elmajdub, Nahed Brebesh, Annis Maatough, Frank Willeke, Christel Weiss, Ibrahim Darwich

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Observational
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ahmed ElmajdubMarien-Krankenhaus Siegen: Marien Kliniken Siegen, Siegen, Germany. a.elmajdub@mariengesellschaft.de.ORCID http://orcid.org/0009-0001-2215-6968
Nahed BrebeshDepartment of Surgery, Tripoli University, Tripoli, Libya.ORCID https://orcid.org/0009-0003-6427-0288
Annis MaatoughTrauma and Orthopaedic Department, East Kent Hospitals University NHS Foundation Trust, Kent, UK.ORCID https://orcid.org/0000-0002-9336-7076
Frank WillekeMarien-Krankenhaus Siegen: Marien Kliniken Siegen, Siegen, Germany.ORCID https://orcid.org/0000-0003-1684-2942
Christel WeissInstitute of Medical Statistics, Biomathematics and Information Processing, Universitätsklinikum Mannheim, Mannheim, Germany.ORCID https://orcid.org/0000-0002-8692-5690
Ibrahim DarwichMarien-Krankenhaus Siegen: Marien Kliniken Siegen, Siegen, Germany.ORCID https://orcid.org/0000-0002-4267-5052

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Anastomotic leaks are a significant complication in colorectal surgery. Indocyanine green fluorescence angiography (ICG-FA) has been suggested as a method to reduce the risk. This meta-analysis aims to evaluate the effect of ICG-FA on reducing anastomotic leaks in colorectal surgery. This study follows PRISMA guidelines and is registered on PROSPERO (CRD42022370748). We conducted a comprehensive search of multiple databases and registers for randomized controlled trials (RCTs) comparing ICG-FA with standard methods in colorectal surgery. Data extraction and quality assessment were performed by two independent reviewers, with a third resolving disputes. Odds ratios (OR) and mean differences (MD) were calculated using comprehensive meta-analysis software, version 3. Heterogeneity and publication bias were assessed, and a sensitivity analysis was performed. The analysis included five RCTs with a total of 1369 patients from four countries. The ICG-FA was associated with a 45% reduction in the risk of overall anastomotic leaks (OR: 0.550, p = 0.012). Subgroup analysis showed a 47% reduction in leaks for low anastomoses (OR: 0.53, p = 0.143) and a 69% reduction in grade A leaks (OR: 0.31, p = 0.008). No significant effects were observed for grade B and C leaks, blood loss, surgery duration, hospital stay, mortality, postoperative ileus, reoperation, or surgical site infections. ICG-FA significantly reduces the overall risk of anastomotic leaks, especially grade A leaks, and shows a trend towards fewer leaks in low anastomosis. No significant impact was found on secondary outcomes. Further RCTs are needed to confirm these findings.

Indexed as

Anastomotic LeakColonFluorescein AngiographyIndocyanine GreenRectumAnastomosis, SurgicalColoring AgentsHumansRandomized Controlled Trials as TopicColoring AgentsIndocyanine GreenAnastomotic leakColectomyColorectal resectionFluorescence angiographyHemicolectomyIndocyanine green

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.