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Does Intraoperative Indocyanine Green Fluorescence Angiography Decrease the Incidence of Anastomotic Leakage in Colorectal Surgery? A Systematic Review and Meta-Analysis

ABSTRACT Background Colorectal anastomoses in patients with colorectal cancer carry a high risk of leakage. Indocyanine green fluorescence angiography (ICG-FA) is a new technique that allows surgeons to assess the blood perfusion of the anastomosis during operation. This meta-analysis aimed to evaluate whether ICG-FA could prevent anastomotic leakage (AL) in colorectal surgery. Methods Four databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched to identify suitable literatures until March 2020 that compared AL rates between intraoperative use and non-use of ICG-FA in...

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The Impact of Indocyanine-green Fluorescence Angiography on Intraoperative Decision-making and Postoperative Outcome in Free Flap Surgery

ABSTRACT Background Reliable perfusion of the distal portions of free flaps is decisive for the reconstructive success. Indocyanine green near-infrared video angiography (ICG-NIR-VA) has been adopted for objective assessment of free flap tissue perfusion but is thus far not used on a routine basis. Therefore, we investigated its intraoperative impact on decision-making and postoperative outcome. Methods From January 2017 to June 2019, 88 consecutive adipo- or fasciocutaneus free flaps were performed in conjunction with intraoperative ICG-NIR-VA. Free flap tissue perfusion was first assessed...

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Intraureteral Indocyanine Green Augments Ureteral Identification And Avoidance During Complex Robotic‐assisted Colorectal Surgery

ABSTRACT Aim Up to 10% of patients undergoing non‐urologic abdominopelvic operations suffer a ureteral injury. While preoperative ureteral stenting to facilitate ureteral identification is common, it does not reduce the incidence of intraoperative ureteral injury and is not without risk. As we continue to broaden the application of minimally invasive surgical techniques, a new form of ureteral identification and avoidance, which does not rely on tactile feedback, is needed. We report our initial experience with intraureteral indocyanine green (ICG) for ureteral identification and avoidance...

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Indocyanine Green Fluorescence Angiography and the Incidence of Anastomotic Leak after Colorectal Resection for Colorectal Cancer: A Meta-analysis

ABSTRACT BACKGROUND Anastomotic leak is a life-threatening complication of colorectal surgery. Recent studies showed that indocyanine green fluorescence angiography might be a method to prevent anastomotic leak. OBJECTIVE The purpose of this study was to investigate whether intraoperative indocyanine green fluorescence angiography can reduce the incidence of anastomotic leak. DATA SOURCES Potential relevant studies were identified from the following databases: PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure. STUDY SELECTION This meta-analysis...

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Indocyanine Green Fluorescence Angiography Decreases the Risk of Colorectal Anastomotic Leakage: Systematic Review and Meta-analysis

Background Anastomotic leakage after a colorectal resection results in devastating consequences for patients. Indocyanine green fluorescence angiography is a modality to visualize vascular perfusion at the anastomotic site and can help surgeons decide the viability of the anastomosis. We performed this systematic review and meta-analysis to evaluate the efficacy of indocyanine green fluorescence angiography in decreasing anastomotic leakage. Methods PubMed, Web of Science, Embase, and the Cochrane Library were searched to identify studies comparing the use of indocyanine green fluorescence...

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Use of Near-infrared Incisionless Fluorescent Cholangiography (Nifc) for Identification of the Anatomy in Biliary Surgery

Case Report The following case study discusses a 37 years old, morbidly obese woman (BMI 43 Kg/m2) with impaired fasting glucose and no significant surgical history who presented to the clinic with a 3-month history of right upper quadrant (RUQ) abdominal pain, especially after meals. The physical exam revealed tenderness in the RUQ with a negative Murphy sign and no evidence of peritonitis. An ultrasound showed a 3.8 cm gallstone (Figure 1) without gallbladder wall thickening and hepatic steatosis. Esophagogastroduodenoscopy did not reveal any pathologic findings. The patient was referred...

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Indocyanine Green Perfusion Assessment During Colonic Interposition for Graft Necrosis after Esophagectomy

Case Report A 72-year-old Caucasian male with a past medical history of type 2 diabetes mellitus, hypertension, hyperlipidemia, myocardial infarction, gastric ulcer, gastroesophageal reflux disease (GERD), presented to the clinic complaining of lower chest discomfort and progressive dysphagia to both liquid and solid food for approximately four months. At the endoscopy he was found to have a long segmental papillomatous lesion in the distal esophagus and extending into the proximal stomach. Pathological examination of the biopsy confirmed a squamous cell carcinoma. Computed tomography (CT)...

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