Rogers, P; Dourado, J; Wignakumar, A; Weiss, B; Aeschbacher, P; Garoufalia, Z; Strassmann, V; Emile, S; Strzempek, P; Wexner, S (2024). The role of ureteric indocyanine green fluorescence in colorectal surgery: a retrospective cohort study. Techniques in coloproctology, 28(83) Springer 10.1007/s10151-024-02955-x
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BACKGROUND
Ureteric injury (UI) is an infrequent but serious complication of colorectal surgery. Prophylactic ureteric stenting is employed to avoid UI, yet its efficacy remains debated. Intraoperative indocyanine green fluorescence imaging (ICG-FI) has been used to facilitate ureter detection. This study aimed to investigate the role of ICG-FI in identification of ureters during colorectal surgery and its impact on the incidence of UI.
METHODS
A retrospective cohort study involving 556 consecutive patients who underwent colorectal surgery between 2018 and 2023 assessed the utility of routine prophylactic ureteric stenting with adjunctive ICG-FI. Patients with ICG-FI were compared to those without ICG-FI. Demographic data, operative details, and postoperative morbidity were analyzed. Statistical analysis included univariable regression.
RESULTS
Ureteric ICG-FI was used in 312 (56.1%) patients, whereas 43.9% were controls. Both groups were comparable in terms of demographics except for a higher prevalence of prior abdominal surgeries in the ICG-FI group. Although intraoperative visualization was significantly higher in the ICG-FI group (95.3% vs 89.1%; p = 0.011), the incidence of UI was similar between groups (0.3% vs 0.8%; p = 0.585). Postoperative complications were similar between the two groups. Median stent insertion time was longer in the ICG-FI group (32 vs 25 min; p = 0.001).
CONCLUSION
Ureteric ICG-FI improved intraoperative visualization of the ureters but was not associated with a reduced UI rate. Median stent insertion time increased with use of ureteric ICG-FI, but total operative time did not. Despite its limitations, this study is the largest of its kind suggesting that ureteric ICG-FI may be a valuable adjunct to facilitate ureteric visualization during colorectal surgery.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine |
UniBE Contributor: |
Aeschbacher, Pauline |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1128-045X |
Publisher: |
Springer |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
11 Jul 2024 08:35 |
Last Modified: |
11 Jul 2024 08:44 |
Publisher DOI: |
10.1007/s10151-024-02955-x |
PubMed ID: |
38985353 |
Uncontrolled Keywords: |
Colorectal surgery Fluorescence imaging Identification Indocyanine green Ureters |
BORIS DOI: |
10.48350/198899 |
URI: |
https://boris.unibe.ch/id/eprint/198899 |
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