TITLE:
Efficacy of the Intraoperative Use of Indocyanine-Green Fluorescence Angiography in Laparoscopic Rectal Resections
AUTHORS:
Jingkun Shang, Jingping He, Shouru Zhang, Maocai Tang, Ziling Zheng, Hao Sun
KEYWORDS:
Laparoscopic Rectal Resection, Indocyanine, Rectal Cancer
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.13 No.9,
August
30,
2022
ABSTRACT: Background: In
traditional laparoscopic colorectal cancer surgery, the surgeon’s
method assess intestinal stumps blood supply is subject to certain subjectivity
and blindness. Indocyanine green (ICG) real-time blood perfusion fluorescence
angiography in laparoscopic radical resection of rectal cancer has great potential clinical value and can visually
judge intestinal tract blood supply to improve the surgery safety,
reduce postoperative complications, and ensure the recovery of patients after
surgery. Objective: To explore the efficacy of the intraoperative use of
indocyanine-green fluorescence angiography in laparoscopic rectal resections in
patients with rectal cancer. Methods: In the
present study, 109 rectal cancer patients were included and assigned to
different surgical groups [ICG and control groups] for analysis. Statistical
analysis was carried out for various common postoperative complications in the
two groups. Finally, the patients in the ICG fluorescence imaging group had a
timely adjustment of the proximal resection of the intestinal tube before the
proximal bowel of the lesion was cut off when the intestinal blood supply was insufficiently
assessed by fluorescence imaging. Two subgroups, the adjustment and the
non-adjustment groups, were analyzed. Results: Compared with the control
group, the postoperative anal ventilation time in the ICG group was shorter
than that in the control group (P 0.05). In
addition, the postoperative complications were lower than those in the control
group, and the differences were statistically significant (P 0.05). However, the distance between the tumor from
the anal verge in the adjustment group was smaller than that in the
non-adjustment group, and the difference was statistically significant (P 0.01). Conclusion: Compared with conventional laparoscopic
radical resection of rectal cancer, ICG real-time indocyanine green fluore- scence angiography
was safe and feasible. This technique is a promising intraoperative tool for the assessment of bowel perfusion especially suitable
for patients with lower rectal cancer.