Journal
INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY
Volume 12, Issue 4, Pages 710-717Publisher
WILEY-BLACKWELL
DOI: 10.1002/rcs.1710
Keywords
rectal cancer; sphincter-saving operation; robot-assisted; indocyanine green; fluorescence
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Funding
- Korea Research Foundation [2013R1A2A1A03070986]
- Ministry of Science, ICT, Future Planning
- Korea Health 21 RD Project [HI06C0868, HI13C1750]
- Ministry of Health, Welfare and Family Affairs, Republic of Korea
- National Research Foundation of Korea [2013R1A2A1A03070986] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
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Background There have been few studies describing the use of indocyanine green (ICG) fluorescent imaging during robot-assisted (RA) sphincter-saving operations (SSOs) and assessing its potential role in reducing anastomotic leak (AL). Methods A consecutive cohort of 436 rectal cancer patients who underwent curative RA SSOs were prospectively enrolled during 2010-2014, including 123 patients with ICG imaging (ICG(+) group) and 313 patients without ICG imaging (ICG(-) group). Results ICG imaging appeared to be helpful in identifying competent perfusion of the bowel adjacent to the anastomosis in 13 patients (10.6%) who might be susceptible to bowel ischaemia, including restrictive mesocolon. AL was remarkably greater in the ICG(-) group compared with the ICG(+) group (5.4% vs 0.8%; p = 0.031). Conclusions ICG imaging during RA SSO provides accurate real-time knowledge of the perfusion status at or near the anastomosis, specifically reducing AL in patients who may incur bowel ischaemia. Copyright (C) 2015 John Wiley & Sons, Ltd.
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