Evidence map›Paper›PMID 42443689›Full record

ArticleSurgical endoscopy2026

Colorectal anastomotic safety assessment using ICG fluorescence and flexible endoscopy (COLOSSEUM): a global survey of 1367 surgeons.

A Belvedere, E Licardie, D Sochorova, L Boni, M Chand, S Perretta, S Wexner, T H A Arulampalam, S Morales-Conde, S F Hardon and 1 more

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Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

A BelvedereDepartment of General and Emergency Surgery, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
E LicardieDepartment of General and Digestive Surgery, University Hospital Virgen Macarena, University of Sevilla, Seville, Spain.
D SochorovaDepartment of Surgery, Tomas Bata Hospital, Zlin, Czech Republic.
L BoniDepartment of General & Minimally Invasive Surgery, Fondazione IRCCS - Ca' Granda - Ospedale Maggiore Policlinico di Milan, Milan, Italy.
M ChandDepartment of Advanced Minimally-Invasive Surgery, University College London Hospital, London, UK.
S PerrettaDepartment of Surgery, University Hospital, Strasbourg, France.
S WexnerDepartment of Colorectal Surgery, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
T H A ArulampalamSchool of Medicine, Anglia Ruskin University, Chelmsford, UK.
S Morales-CondeDepartment of General and Digestive Surgery, University Hospital Virgen Macarena, University of Sevilla, Seville, Spain.
S F HardonDepartment of Surgery, Amsterdam UMC, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands. s.hardon@amsterdamumc.nl.ORCID http://orcid.org/0000-0003-0876-0242
COLOrectal Surgical Safety Enhanced Using Mixed Methods (COLOSSEUM) Collaborative group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimAnastomotic leakage remains a major complication in colorectal surgery. Indocyanine green (ICG) fluorescence and flexible endoscopy (FE) are used to assess perfusion and anastomotic integrity. We aimed to evaluate global practice patterns and intersurgeon variability to inform structured recommendations.

methodsThis international survey was conducted between April and November 2024 within the EAES Rising Stars Academy 2023-2024. In a Delphi-like process, 53 questions addressing surgeon characteristics, institutional practice, and the use of ICG and FE were developed and distributed worldwide.

resultsA total of 1367 respondents from 80 countries participated (mean age 64 ± 10 years). ICG was available at 76% of institutions, and 67% of surgeons reported using it. Timing varied: before transection 40%, after transection 7%, before anastomosis 17%, after anastomosis 25%, and both before and after 11%. A fixed dose was used by 71% and weight-based dosing by 29%. FE was performed by 51% of surgeons, with 23% reporting routine intraoperative use. Key barriers included gastroenterologist-led practice (28%), reliance on alternative techniques (20%), and lack of training (19%). Substantial variability was observed across all domains.

conclusionsThis survey revealed significant heterogeneity in the use of ICG and FE in colorectal surgery. Although ICG is more widely implemented, both techniques lack standardized protocols. Moreover, FE adoption remains limited by training and access. Training should be enhanced and could represent a key area of focus for future EAES programs.

Indexed as

Anastomotic LeakColonIndocyanine GreenPractice Patterns, Physicians'RectumAnastomosis, SurgicalColorectal Surgical ProceduresColoring AgentsFemaleHumansMaleMiddle AgedSurveys and QuestionnairesColoring AgentsIndocyanine GreenAnastomotic leakColorectal anastomosisColorectal surgeryEndoscopyICG fluorescence

Identifiers

PMID42443689
PMCPMC13582295

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.