Table 1.
Clinical studies regarding the role of near-infrared (NIR) indocyanine green (ICG) in preventing anastomotic leaks (AL) post-colorectal surgery; the first nine studies [13,17,25,29,32,34,35,36] refer to the use of ICG in all colorectal diseases; the following 14 refer to left colon and rectal surgeries only [19,20,21,22,23,24,26,27,28,30,31,33,37,38].
| Study, Year |
No. Cases (NIR; Control) | Pathology | Type of Surgery | Fluorescence Assessment | Dose | Decision Change | AL% (NIR; Control) | Image Acquisition Device |
|---|---|---|---|---|---|---|---|---|
| Ris, F.; et al. [13], 2018 |
504 NIR only | B/M colorectal diseases (all locations) |
Laparoscopy/open/conversion colorectal surgery |
Intraperitoneal | 7.5 mL before and after | 5.8% | 2.4% (none in those with revised surgery) | PINPOINT, Stryker |
| Ohya, H.; et al. [17], 2020 |
n = 400 NIR only |
Colon/appendiceal cancer (all locations) |
Laparoscopic colectomies | Intraperitoneal | 0.25 mg/kg | 2.8% (mostly transverse and left colon anastomosis) | 1% | IMAGE1 S, Karl Storz PINPOINT, Stryker |
| Kin, C.; et al. [18], 2015 | 346 (173;173 historically matched) | M/B colorectal diseases (all locations) |
Laparoscopic colorectal surgery | Intraperitoneal | No info | 5% | 7.5% 6.4% |
No info |
| Boni, L.; et al. [25], 2017 | n = 107, NIR only | Colorectal cancer, all locations | Laparoscopic right/left hemicolectomy, AR | Intraperitoneal | 0.2 mg/kg before and after |
3.8% | 0.9% (due to stapler related deficiency) | IMAGE1 S, Karl Storz |
| Su, H.; et al. [29], 2020 |
189 (84;105) | Colon cancer, >30 cm anal verge | Totally laparoscopic colic resection | Intraperitoneal | Before and after 7.5 mg (3 mL) | 4.8% | 0% 0% 0% stricture |
opto-cam 2100 (Optomedic, Guangdong, China) |
| Ogino, T.; et al. [32], 2018 | 74, NIR only | B/M colorectal diseases (all locations) |
Laparoscopy/open colorectal surgery |
Extraperitoneal | 5 mg before | 8.1% | 1.4% (1 case, not related to ischemia) | Photodynamic Eye System, Hamamatsu Photonics |
| Tsang, Y.; et al. [34], 2020 | 131 (63;68) | B/M colorectal diseases (all locations) |
Laparoscopic/robotic colorectal surgery | Intraperitoneal | 10 mg before | 1.6% | 3.23% 4.35% |
Firefly, da Vinci Xi Olympus OTV-S300 CLV-S200-IR (Olympus, Tokyo, Japan) |
| Nishigori, N.; et al. [35], 2016 | 21 NIR only | Colorectal cancer (all locations) |
Laparoscopic colorectal surgery | Intraperitoneal | 1–3 mL (2.5 mg/mL) | 16.7% | 0% | D-Light P System/Image 1 SPIES, Karl Stortz; infrared endoscopic camera system, Olympus (Tokyo, Japan) |
| Santi, C.; et al. [36], 2019 | 38, NIR only | Colorectal cancer, all locations | Laparoscopic colic resection | Intraperitoneal | 5 mL (0,3 mg/kg) before | 2.6% | 2.6% (mechanical cause) | IMAGE1S, Karl Storz |
| Sherwinter, D.A.; et al. [19], 2012 | n = 20 NIR only | B/M Rectal diseases |
Laparoscopic LAR | Endoscopy, transanal | 1 mL 2.5 mg | N/A 4 cases with hipofluoresce—decision not changed |
10% (managed conservatory)—CT diagnosed | PINPOINT, Novadaq (Canada) |
| Kawada, K.; et al. [20], 2016 | n = 68 NIR only | Left colorectal cancer | Laparoscopic colorectal surgery | Specimen extracted by the umbilical trocar and examined |
5 mg | 26.5% | 4.5% (symptomatic) |
PDE-neo system, Hamamatsu Photonics |
| Somerskhar, J.P.; et al. [21], 2020 | n = 50 NIR only | Colorectal cancer | Robotic Sigmoid colectomy, LAR +ileostomy |
Intraperitoneal | 3 mL, 2.5 mg/mL | 88% | 0% | FIREFLY, da Vinci |
| Jafari, M.D.; et al. [22], 2013 |
n = 38 (16;22) |
Rectal cancer | Robotic-assisted AR | Intraperitoneal | 6–8 mg before | 18.75% | 6% 18% |
FIREFLY, da Vinci |
| Grone, J.; et al. [23], 2015 | n = 18, ICG only | Rectal cancer | Laparoscopic AR (1 conversion) | Intraperitoneal | 10 mg before and after | 27.8% | 6% (compared to 15% historically, same center) | PINPOINT, Novadaq |
| Hellan, M.; et al. [24], 2014 | n = 40, ICG only | Left colorectal cancer | Robotic-assisted left colorectal surgery | Intraperitoneal | 10 mg ICG | 40% | 5% (with revised anastomosis) | FIREFLY, da Vinci |
| Jafari, M.D.; et al. [26], 2014 | n = 139, NIR only | Left colorectal cancer | Laparoscopy-assisted left colectomy, AR | Intraperitoneal | 3.75-7.5 mg before and after |
8% | 1.4% (no AL in cases with changed decision) |
PINPOINT, Novadaq |
| De Nardi, P.; et al. [27], 2020 |
n = 240 (118;122) |
Left colorectal B/M diseases | Laparoscopic AR, LAR, left colectomy |
Intraperitoneal | 0.3 mg/kg before and after | 11% | 5% 9% |
IMAGE1 S, Karl Storz |
| Kim, J.C.; et al. [28]. 2016 | 426 (123; 313) | Rectal cancer | Robotic-assisted sphincter-saving operations | Intraperitoneal | 10 mg (before+/- after) | Not applicable (site chosen by NIR) | 0.8% 5.4% |
FIREFLY, da Vinci |
| Mizrahi, I.; et al. [30], 2018 | 60 (30;30) | Low rectal cancer, <5 cm anal verge | Laparoscopic LAR | Intraperitoneal | 0.1–0.3 mg/kg | 13.3% | 0% 6.7% |
PINPOINT, Novadaq |
| Son, G.M.; et al. [31], 2019 | 86, NIR only | Colorectal cancer | Laparoscopic AR (55) Laparoscopic LAR (31) |
Intraperitoneal | 0.25 mg/kg before | Not applicable | 7% good correlation with poor perfusion (TR >0.6) |
IMAGE1 S, Karl Storz |
| Hasegawa, S.; et al. [33], 2020 | 852 (143;709) | Rectal cancer | Laparoscopic LAR, ISR | Intraperitoneal | 5 mg before | 17.0% | 2.8% 12.4% |
IMAGE1 S, Karl Storz; 1588 AIM and SPY (Stryker), HyperEye (Mizuho Medical) |
| Watanabe, J.; et al. [37], 2020 |
550 (236;314) | Low rectal cancer | Laparoscopic LAR | Intraperitoneal | 0.25mg/kg | 5.7% | 4.7% 10.4% |
D-Light P, Karl Storz; 1588 AIM Platform, Stryker |
| Wada, T.; et al. [38], 2019 | 149 (48;101) | Low rectal cancer | Laparoscopic LAR | Specimen exteriorized by the umbilical trocar and examined | 5 mg before | 27.1% | 8.8% 14.7% |
PDE-neo system, Hamamatsu Photonics |