SynthesisSurgical endoscopy2026
Indocyanine green fluorescence imaging in minimally invasive liver resection for colorectal liver metastases: lesion detection and surgical outcomes-a systematic review and meta-analysis.
Synthesis in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
backgroundIndocyanine green (ICG) fluorescence imaging is used during minimally invasive liver resection for colorectal liver metastases (CRLM), but disease-specific evidence is limited and has often mixed patient-level and lesion-level outcomes.
methodsSix databases were searched to May 14, 2026. We prespecified lesion-detection and surgical-outcome modules. Primary quantitative analyses required fully separable CRLM numerators and denominators. Patient-level and lesion-level R0 outcomes were analyzed separately. Random-effects logit models used Paule-Mandel variance and Hartung-Knapp 95% confidence intervals (CIs). Diagnostic studies were assessed with QUADAS-2 and surgical cohorts with the Newcastle-Ottawa Scale.
resultsEighteen eligible reports represented 17 unique cohorts; one earlier report was excluded from quantitative synthesis because its cohort was nested in a later study. Patient-level R0 resection was reported in four studies (146/155 patients) and pooled at 92.5% (95% CI 62.7-98.9%; I
conclusionsICG fluorescence imaging is feasible for lesion visualization and margin-oriented navigation in selected CRLM patients at experienced centers. Evidence remains insufficient to establish comparative benefit over conventional minimally invasive resection. Adequately powered randomized trials with standardized ICG and intraoperative-ultrasonography protocols and patient-centered oncologic outcomes are essential.
trial registrationPROSPERO registration: CRD420261394514.
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