SynthesisMedicine2025
Impact of indocyanine green fluorescence angiography on the prevention of anastomotic leakage in mid- and low-rectal cancer surgery: A systematic review and meta-analysis.
Synthesis in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe cause of AL in rectal cancer surgery is multifactorial. The impact of indocyanine green fluorescence angiography (ICG-FA)-based assessment of blood flow on anastomotic leakage (AL) prevention in low- and mid-rectal cancer surgery is unclear. The aim of this meta-analysis was to evaluate that impact.
methodsThe MEDLINE, Cochrane Library, and Scopus databases were searched for articles published up to September 19, 2025 in which the association between ICG-FA and outcomes of rectal cancer surgery was assessed. Data were pooled for meta-analysis. The primary outcome was the AL rate in mid- and low-rectal cancer surgery. Secondary outcomes included severity of AL, diverting-stoma construction rates, and changes in surgical plans based on ICG-FA. Subgroup analysis for low-rectal cancer surgery was performed on the AL rate.
resultsEight studies (1286 patients) met the eligibility criteria, comprising 1 randomized controlled trial, 1 before-and-after prospective study, and 6 retrospective studies. The analysis involved 560 patients in the ICG-FA group and 726 in the control group. ICG-FA was associated with a significantly lower AL rate in mid- and low-rectal cancer surgeries (odds ratio [OR], 0.34; 95% confidence interval [CI], 0.22-0.51; P < .001), grade-A AL rate (OR, 0.17; 95% CI, 0.07-0.41; P < .001), and grade-B and grade C AL rate (OR, 0.41; 95% CI, 0.18-0.91; P = .03) compared to the control group. The diverting-stoma construction rate was comparable between the ICG-FA and control groups. The weighted mean rate of change in the surgical plan based on ICG-FA was 17.0% (95% CI, 10%-29%). In the subgroup analysis, ICG-FA was associated with a significantly lower AL rate in low-rectal cancer surgeries compared to that in the control group (OR, 0.36; 95% CI, 0.21-0.62; P < .001).
conclusionIn surgery for mid- and low- rectal cancer, ICG-FA-based blood-flow assessment is an important factor in reducing AL. Further randomized controlled trials that are focused on mid- and low-rectal cancer are warranted to confirm these benefits and establish the role of ICG-FA in clinical practice.
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