AB123. SOH25_AB_365. Quantitative analysis of indocyanine green fluorescence angiography in colorectal surgery: a systematic review of the literature
Systematic Reviews Session

AB123. SOH25_AB_365. Quantitative analysis of indocyanine green fluorescence angiography in colorectal surgery: a systematic review of the literature

Philip McEntee1, Ashokkumar Singaravelu2, Cathleen McCarrick1, Edward Murphy1, Patrick Boland1, Ronan Cahill1

1Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland; 2University College Dublin Centre for Precision Surgery, Dublin, Ireland

Background: Indocyanine green fluorescence angiography (ICGFA) during colorectal surgery is associated with reduced rates of post-operative anastomotic complications. Because interpretation of ICGFA is subjective, quantification has been proposed to address inter-user variability. This study reviews the published literature regarding ICGFA quantification during colorectal surgery with a focus on clinical deployment.

Methods: A systematic review of English language publications was performed in PubMed, Scopus, Web of Science and Cochrane Library on 29th August 2024, updated to 18th November 2024 following PRISMA guidelines. All clinical studies referencing ICGFA quantification during colorectal surgery were included with the Newcastle Ottawa scale used to assess quality.

Results: A total of 1,428 studies were screened, resulting in the selection of 22 studies (1,469 patients). Significant heterogeneity of ICGFA methodology, quantification methods, and parameter selection was noted with only three being scored “high” quality. Four studies (154 patients) conducted real-time analyses of the fluorescence signal (others were post-hoc analyses) and four utilised artificial intelligence methods. Eleven studies only included patients undergoing left-sided resection, with six of these focusing specifically on rectal resections. Only one study employed the quantification method to guide intra-operative decision-making regarding transection of the colonic segment. Twenty-six different perfusion parameters were assessed, with time from injection to visible fluorescence and maximum intensity the most commonly (but not only) correlated parameters regarding anastomotic complication.

Conclusions: Quantification of the ICGFA signal for colorectal surgery is feasible but has so far seen limited academic advancement beyond feasibility.

Keywords: Indocyanine green fluorescence angiography (ICGFA); quantification; colorectal surgery; anastomotic complication; systematic review of the literature

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab123
Cite this abstract as: McEntee P, Singaravelu A, McCarrick C, Murphy E, Boland P, Cahill R. AB123. SOH25_AB_365. Quantitative analysis of indocyanine green fluorescence angiography in colorectal surgery: a systematic review of the literature. Mesentery Peritoneum 2025;9:AB123.

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