BACKGROUND Colonic perfusion is crucial for anastomotic healing and this could be evaluated intraoperatively using indocyanine-green fluorescence imaging (ICG FI). The aim of this study was to ascertain whether the use of ICG FI resulted in the reduction of anastomotic complications, i.e. AL and anastomotic stricture. METHODS Consecutive patients who underwent anterior resections or low anterior resections at our institution in the period from January 1st 2013 to December 31st 2018 were retrospectively reviewed. Surgery performed during the period from January 1st 2013 to December 31st 2015 did not involve the use of ICG FI (ICG-) while surgery during the period from January 1st 2016 to December 31st 2018 was performed with the use of ICG FI (ICG+). The anastomotic leakage rates of the two groups were compared after propensity score matching, taking into account the height of the anastomosis and any history of pelvic irradiation. RESULTS There was a total of 258 and 317 patients who had surgery with and without ICG FI, respectively. There were 253 patients in each group after propensity score matching. The overall anastomotic leakage rate was 3.6% and 7.9% for ICG+ and ICG-, respectively, (p = 0.035). Subgroup analysis showed that the use of ICG FI was significantly associated with a lower anastomotic leakage rate in total mesorectal excision (TME), 4.7% versus 11.6%, p = 0.043, but not in non-TME resections, 3.5% versus 2.4%, (p = 0.612). ICG FI, together with sex and anastomotic height, were independent predictors of anastomotic leakage. CONCLUSIONS The routine use of ICG FI was associated with a lower anastomotic leakage rate in anterior resections. The reduction in anastomotic leakage rate was mainly seen in TME.

中文翻译：

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在前切除术中用吲哚菁绿荧光成像进行结肠灌注评估：倾向评分匹配分析。

背景技术结肠灌注对于吻合口愈合至关重要，这可以在术中使用吲哚菁绿荧光成像（ICG FI）进行评估。这项研究的目的是确定使用ICG FI是否可以减少吻合口并发症，即AL和吻合口狭窄。方法回顾性分析2013年1月1日至2018年12月31日在我院接受前切除或低前切除的连续性患者。在2013年1月1日至2015年12月31日期间进行的手术未涉及使用ICG FI（ICG-），而在2016年1月1日至2018年12月31日期间进行的手术则使用了ICG FI（ICG +）。倾向评分匹配后比较两组的吻合口漏率，考虑到吻合高度和盆腔放疗史。结果分别有258例和317例接受或不接受ICG FI手术的患者。倾向评分匹配后，每组有253例患者。ICG +和ICG-的总吻合口漏率分别为3.6％和7.9％（p = 0.035）。亚组分析显示，ICG FI的使用与总直肠系膜切除术（TME）较低的吻合口漏率显着相关，分别为4.7％和11.6％，p = 0.043，但在非TME切除术中则没有，分别为3.5％和2.4％， （p ＝ 0.612）。ICG FI以及性别和吻合口高度是吻合口泄漏的独立预测因子。结论常规使用ICG FI与前切除术中较低的吻合口漏率相关。