Indocyanine green fluorescence angiography in colorrectal surgery. First case series in Mexico

Abstract

Introduction and aim: Anastomotic leak occurs in 1-19% of colorrectal surgeries. Our objective was to present the first Mexican case series on colorrectal surgery using indocyanine green fluorescence angiography to evaluate perfusion prior to carrying out the anastomosis.

Materials and methods: A retrospective, analytic, descriptive study was conducted. We studied the case records of consecutive patients that underwent colorrectal surgery with indocyanine green angiography performed by the same group of colorrectal surgeons.

Results: Twenty-one case records were reviewed. Eleven (52.3%) of the patients were women, mean patient age was 57 years (38-82), and mean body mass index was 25 kg/m² (17-34). Fifteen (71.4%) patients were diagnosed with malignant disease. Indocyanine green angiography changed our therapeutic decision in three (14.2%) patients. Two colorrectal anastomoses (14.2%) were performed at fewer than 5 cm from the anal verge and 13 (61.9%) were performed at more than 5 cm from the anal verge. Three of the anastomoses were ileocolic (14.2%), two were coloanal (9.5%), and one was ileoanal (4.7%). There were six (28.5%) complications, no cases of anastomotic leak, and no complications associated with the use of indocyanine green. The mortality rate was 0%.

Conclusion: The present case series is the first on colorrectal surgery conducted in Mexico using indocyanine green fluorescence angiography, with excellent results.

Keywords: Cirugía colorectal; Cirugía colorrectal; Dehiscencia de anastomosis; Inmunofluorescencia con verde de indocianina; México.