Annals of Coloproctology

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Complication,Biomarker & risk factor

Intraoperative fluorescence angiography as an independent factor of anastomotic leakage and a nomogram for predicting leak for colorectal anastomoses: Mikhail Alekseev, Evgeny Rybakov, Evgeniy Khomyakov, Irina Zarodnyuk, Yuri Shelygin; Ann Coloproctol. 2022;38(5):380-386. Published online July 22, 2021; DOI: https://doi.org/10.3393/ac.2021.00171.0024

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179 Download
12 Web of Science
17 Citations

Purpose
Colorectal anastomotic leakage (AL) is a life-threatening complication, which increases morbidity, hospital stay and cost of treatment. The aim of this study is to identify risk factors, including intraoperative indocyanine green fluorescence angiography (ICG FA), associated with the leak of stapled colorectal anastomosis.
Methods
Four hundred twenty-nine consecutive patients underwent surgery between 2017 and 2019 for benign (n=10, 2.3%) or malignant (n=419, 97.7%) and rectal (n=349, 81.4%) or distal sigmoid (n=80, 18.6%) lesions with double-stapling technique reconstruction were included into retrospective study. Univariate analysis and multivariate logistic regression of the tumor-, patient- and treatment-related risk factors of AL was performed.
Results
An AL developed in 52 patients (12.1%). In multivariate analysis following variables were independently associated with AL; male sex (odds ratio [OR], 3.8; 95% confidence interval [CI], 1.9−7.7; P<0.01), anastomosis at ≤6.5 cm from anal verge (OR, 3.1; 95% CI, 1.3−7.5; P=0.01), and age of ≤62.5 years (OR, 2.1; 95% CI, 1.1−4.1; P=0.03). ICG FA was found as independent factor reducing colorectal AL rate (OR, 0.4; 95% CI, 0.2−0.8; P=0.02). A nomogram with high discriminative ability (concordance index, 0.81) was created.
Conclusion
ICG FA is a modifiable surgery-related risk factor associated with a decrease of colorectal AL rate. A suggested nomogram, which takes into consideration ICG FA, might be helpful to identify the individual risk of AL.

Citations

Citations to this article as recorded by

Multiple robotic stapler firings to transect the rectum are not associated with anastomotic leakage
Stefano Cardelli, Luca Stocchi, Amit Merchea, Dorin T. Colibaseanu, Michelle F. DeLeon, Nitin Mishra, Kevin J. Hancock, David W. Larson
Colorectal Disease.2025;[Epub] CrossRef
Prospective analysis of factors influencing the change of the section line based on fluorescence angiography with ICG for colorectal anastomosis
J. R. Gómez-López, A. Balla, E. Licardie, S. Morales-Conde
Techniques in Coloproctology.2025;[Epub] CrossRef
Perfil epidemiológico de pacientes submetidos a cirurgias colorretais e análise da incidência de fístulas anastomóticas em hospital secundário - de 2019 a 2024
Davidson Anthony Aragão Freire, Carla Camila Bezerra Rocha, Matthaus Rabelo da Costa, Bruno Gadelha Bezerra, Cid Gerardo Paracampos Liberato, Neto Lorena Cavalcante de Lemos
Revista Científica do Hospital e Maternidade José Martiniano Alencar.2025; 4(2): 20. CrossRef
Risk factors for anastomotic fistula after total mesorectal excision: A monocentric retrospective study of 78 patients
Amine Majdoubi, Anass El Aachi, Mohammed El Hammouti, Haïtam Aabalou, Ayoub Kharkhach, Tariq Bouhout, Badr Serji
Clinical Surgical Oncology.2025; 4(3): 100096. CrossRef
SAGES 2025 systematic review and meta-analysis for fluorescence image-guided gastrointestinal surgery using indocyanine green
Panagiotis Kapsampelis, Elisa C. Calabrese, Sunjay S. Kumar, Dena Shehata, Varun Bansal, Katie Carsky, Austin Eason, Himsikhar Khataniar, Stefan Scholz, María Rita Rodríguez-Luna, Nisha Narula, Jeffrey Chiu, Subhashini Ayloo, Farah Husain, Ahmed Abou-Sett
Surgical Endoscopy.2025;[Epub] CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
RISK FACTORS AND PREVENTIVE MEASURES OF SURGICAL COMPLICATIONS IN THE TREATMENT OF RECTAL CANCER
Світлана Віталіївна Маліборська, Y.D. Partykevych, A.E. Kryzhanivska
Art of Medicine.2024; : 282. CrossRef
The impact of powered circular staplers on anastomotic leak in left-sided colorectal cancer surgeries
Hayoung Lee, Yong Sik Yoon, Young Il Kim, Eun Jung Park, Min Hyun Kim, Jong Lyul Lee, Chan Wook Kim, In Ja Park, Seok-Byung Lim
Surgical Endoscopy.2024; 38(10): 6111. CrossRef
Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek
Medicina.2024; 60(12): 1966. CrossRef
Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going?
Christos Tsalikidis, Athanasia Mitsala, Vasileios I. Mentonis, Konstantinos Romanidis, George Pappas-Gogos, Alexandra K. Tsaroucha, Michail Pitiakoudis
Current Oncology.2023; 30(3): 3111. CrossRef
The effect of neoadjuvant treatment on postoperative morbidity in upper rectal cancer
S. N. Lukmonov, Ya. V. Belenkaya, M. S. Lebedko, S. S. Gordeev, Z. Z. Mammadli
Pelvic Surgery and Oncology.2023; 13(2): 46. CrossRef
The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study
Gyung Son, Armaan Nazir, Mi Yun, In Lee, Sun Im, Jae Kwak, Sang-Ho Park, Kwang-Ryul Baek, Ines Gockel
Biomedicines.2023; 11(7): 2029. CrossRef
Risk assessment of rectal anastomotic leakage (RAREAL) after DIXON in non-emergency patients with rectal cancer
Xue-Cong Zheng, Jin-Bo Su, Jin-Jie Zheng
BMC Gastroenterology.2023;[Epub] CrossRef
Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Updates of Risk Factors for Anastomotic Leakage after Colorectal Surgery
Eugenia Claudia Zarnescu, Narcis Octavian Zarnescu, Radu Costea
Diagnostics.2021; 11(12): 2382. CrossRef

Sentinel Lymph Node Analysis in Colorectal Cancer Patients Using One-Step Nucleic Acid Amplification in Combination With Fluorescence and Indocyanine Green: Francesco Esposito, Adele Noviello, Nicola Moles, Enrico Coppola Bottazzi, Mario Baiamonte, Ina Macaione, Umberto Ferbo, Maria Lepore, Antonio Miro, Francesco Crafa; Ann Coloproctol. 2019;35(4):174-180. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.07.21.1

5,352 View
124 Download
6 Web of Science
6 Citations

Abstract PDF

Purpose
Analysis of the sentinel lymph node (SLN) in colorectal cancer (CRC) patients was proposed for more accurate staging and tailored lymphadenectomy. The aim of this study was to assess the ability to predict lymph node (LN) involvement through analysis of the SLN with a one-step nucleic acid (OSNA) technique in combination with peritumoral injection of indocyanine green (ICG) and near-infrared (NIR) lymphangiography in CRC patients.
Methods
A total of 34 patients were enrolled. Overall, 51 LNs were analyzed with OSNA. LNs of 17 patients (50%) were examined simultaneously with hematoxylin and eosin (H&E) and OSNA.
Results
SLN analysis of 17 patients examined with H&E and OSNA revealed that OSNA had a higher sensitivity (1 vs. 0.55), higher negative predictive value (1 vs. 0.66) and higher accuracy (100% vs. 76.4%) in predicting LN involvement. Overall, OSNA showed a sensitivity of 0.69, specificity of 1, accuracy of 88.2%, and stage migration of 8.8%. Compared to those who were OSNA (−), OSNA (+) patients had a greater number of LN metastases (4.8 vs. 0.16, P = 0.04), higher G3 rate (44.4% vs. 4%, P = 0.01), more advanced stage of disease (stage III: 77.8% vs. 16%; P = 0.00) and were more rapidly subjected to adjuvant chemotherapy (39.1 days vs. 50.2 days, P = 0.01).
Conclusion
SLN analysis with OSNA in combination with ICG-NIR lymphangiography is feasible and can detect LN involvement in CRC patients. Furthermore, it allows for more accurate staging reducing the delay between surgery and adjuvant chemotherapy.

Citations

Citations to this article as recorded by

Diagnostic value of one-step nucleic acid amplification for sentinel lymph node metastasis in cytokeratin 19-positive tumors: evidence from bioinformatics and meta-analysis
Ke Li, Min Meng, Weiwei Zhang, Junyi Li, Yiting Wang, Changhui Zhou
Frontiers in Oncology.2024;[Epub] CrossRef
Non-exposed endoscopic wall-inversion surgery with one-step nucleic acid amplification for early gastrointestinal tumors: Personal experience and literature review
Francesco Crafa, Serafino Vanella, Aristide Morante, Onofrio A Catalano, Kelsey L Pomykala, Mario Baiamonte, Maria Godas, Alexandra Antunes, Joaquim Costa Pereira, Valentina Giaccaglia
World Journal of Gastroenterology.2023; 29(24): 3883. CrossRef
Role of one-step nucleic acid amplification in colorectal cancer lymph node metastases detection
Francesco Crafa, Serafino Vanella, Onofrio A Catalano, Kelsey L Pomykala, Mario Baiamonte
World Journal of Gastroenterology.2022; 28(30): 4019. CrossRef
Mapping Lymph Node during Indocyanine Green Fluorescence-Imaging Guided Gastric Oncologic Surgery: Current Applications and Future Directions
Yiqun Liao, Jiahao Zhao, Yuji Chen, Bin Zhao, Yongkun Fang, Fei Wang, Chen Wei, Yichao Ma, Hao Ji, Daorong Wang, Dong Tang
Cancers.2022; 14(20): 5143. CrossRef
The advantage of one‐step nucleic acid amplification for the diagnosis of lymph node metastasis in colorectal cancer patients
Yukiharu Hiyoshi, Takashi Akiyoshi, Yosuke Fukunaga
Annals of Gastroenterological Surgery.2021; 5(1): 60. CrossRef
The evolving role of one-step nucleic acid amplification (OSNA) for the intra-operative detection of lymph node metastases: A diagnostic accuracy meta-analysis
Anastasios Tranoulis, Dimitra Georgiou, Jason Yap, Stephen Attard-Montalto, Jeremy Twigg, Ahmed Elattar, Kavita Singh, Janos Balega, Sean Kehoe
European Journal of Surgical Oncology.2021; 47(6): 1233. CrossRef

Preoperative Tattooing Using Indocyanine Green in Laparoscopic Colorectal Surgery: Sang Jae Lee, Dae Kyung Sohn, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jae Hwan Oh; Ann Coloproctol. 2018;34(4):206-211. Published online July 26, 2018; DOI: https://doi.org/10.3393/ac.2017.09.25

9,339 View
189 Download
19 Web of Science
20 Citations

Abstract PDF

Purpose
The aim of the present study was to evaluate the usefulness of indocyanine green (ICG) as a preoperative marking dye for laparoscopic colorectal surgery.
Methods
Between March 2013 and March 2015, 174 patients underwent preoperative colonoscopic tattooing using 1.0 to 1.5 mL of ICG and saline solution before laparoscopic colorectal surgery. Patients’ medical records and operation videos were retrospectively assessed to evaluate the visibility, duration, and adverse effects of tattooing.
Results
The mean age of the patients was 65 years (range, 34–82 years), and 63.2% of the patients were male. The median interval between tattooing and operation was 1.0 day (range, 0–14 days). Tattoos placed within 2 days of surgery were visualized intraoperatively more frequently than those placed at an earlier date (95% vs. 40%, respectively, P < 0.001). For tattoos placed within 2 days before surgery, the visualization rates by tattoo site were 98.6% (134 of 136) from the ascending colon to the sigmoid colon. The visualization rates at the rectosigmoid colon and rectum were 84% (21 of 25) and 81.3% (13 of 16), respectively (P < 0.001). No complications related to preoperative ICG tattooing occurred.
Conclusion
Endoscopic ICG tattooing is more useful for the preoperative localization of colonic lesions than it is for rectal lesions and should be performed within 2 days before laparoscopic surgery.

Citations

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Enhancing remanent magnetization of injectable hydrogels improves realtime transluminal localization of tumor in hollow soft viscera
Junnan Gu, Yuxuan Sun, Tianyi Zhang, Zhenxing Jiang, Falong Zou, Denglong Cheng, Wentai Cai, Hao Wen, Shenghe Deng, Jun Wang, Shuang Zhao, Quanliang Cao, Yinghao Cao, Zichun Yang, Liang Li, Jun Ouyang, Kailin Cai
Bioactive Materials.2026; 55: 410. CrossRef
Accuracy evaluation of preoperative indocyanine green tattooing and intraoperative colonoscopy in determining surgical resection margins for left-sided colorectal cancer: a retrospective study in Korea
Byung-Soo Park, Sung Hwan Cho, Gyung Mo Son, Hyun Sung Kim, Jin Ook Jang, Dae Gon Ryu, Su Jin Kim, Su Bum Park, Hyung Wook Kim
Journal of Minimally Invasive Surgery.2025; 28(1): 19. CrossRef
Beyond diagnosis: how advanced imaging technologies are shaping modern surgery
Taner Shakir, Dominic Atraszkiewicz, Mohamed Hassouna, Tom Pampiglione, Manish Chand
Artificial Intelligence Surgery.2025; 5(2): 270. CrossRef
Indocyanine Green Tattooing During Colonoscopy as a Guide to Laparoscopic Colorectal Cancer Surgery: A Literature Review
Marzia Varanese, Stefano Arcieri, Augusto Lauro, Cristina Panetta, Chiara Eberspacher, Rossella Palma, Domenico Mascagni, Stefano Pontone
Surgical Innovation.2024; 31(1): 103. CrossRef
Indocyanine-coated fluorescent clips for localization of gastrointestinal tumors
Kyonglin Park, Hongrae Kim, Hyoung-Jun Kim, Yongdoo Choi, Sung-Jae Park, Jae-Suk Park, Min-Kyu Choi, Dae Kyung Sohn
Journal of Innovative Medical Technology.2024; 2(1): 20. CrossRef
Preoperative localization of potentially invisible colonic lesions on the laparoscopic operation field: using autologous blood tattooing
Ji Yeon Mun, Hyunjoon An, Ri Na Yoo, Hyeon-Min Cho, Bong-Hyeon Kye
Annals of Coloproctology.2024; 40(3): 225. CrossRef
A Green Lantern for the Surgeon: A Review on the Use of Indocyanine Green (ICG) in Minimally Invasive Surgery
Pietro Fransvea, Michelangelo Miccini, Fabio Rondelli, Giuseppe Brisinda, Alessandro Costa, Giovanni Maria Garbarino, Gianluca Costa
Journal of Clinical Medicine.2024; 13(16): 4895. CrossRef
Indocyanine Green Fluorescence Guided Surgery in Colorectal Surgery
Zoe Garoufalia, Steven D. Wexner
Journal of Clinical Medicine.2023; 12(2): 494. CrossRef
Preoperative tumor marking with indocyanine green (ICG) prior to minimally invasive colorectal cancer: a systematic review of current literature
Michael K. Konstantinidis, Argyrios Ioannidis, Panteleimon Vassiliu, Nikolaos Arkadopoulos, Ioannis S. Papanikolaou, Konstantinos Stavridis, Gaetano Gallo, Dimitrios Karagiannis, Manish Chand, Steven D. Wexner, Konstantinos Konstantinidis
Frontiers in Surgery.2023;[Epub] CrossRef
Assessment of Autologous Blood marker localIzation and intraoperative coLonoscopy localIzation in laparoscopic colorecTal cancer surgery (ABILITY): a randomized controlled trial
Ke-hui Zhang, Jing-ze Li, Hai-bin Zhang, Ren-hao Hu, Xi-mao Cui, Tao Du, Liang Zheng, Shun Zhang, Chun Song, Mei-dong Xu, Xiao-hua Jiang
BMC Cancer.2023;[Epub] CrossRef
Indocyanine Green tattooing for marking the caudal excision margin of a full-thickness vaginal endometriotic nodule
S Khazali, B Mondelli, K Fleischer, M Adamczyk
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Indocyanine green dye and its application in gastrointestinal surgery: The future is bright green
Zavier Yongxuan Lim, Swetha Mohan, Sunder Balasubramaniam, Saleem Ahmed, Caroline Ching Hsia Siew, Vishal G Shelat
World Journal of Gastrointestinal Surgery.2023; 15(9): 1841. CrossRef
Tumor Segmentation in Colorectal Ultrasound Images Using an Ensemble Transfer Learning Model: Towards Intra-Operative Margin Assessment
Freija Geldof, Constantijn W. A. Pruijssers, Lynn-Jade S. Jong, Dinusha Veluponnar, Theo J. M. Ruers, Behdad Dashtbozorg
Diagnostics.2023; 13(23): 3595. CrossRef
Fluorescence Imaging in Colorectal Surgery: An Updated Review and Future Trends
Paulina Daniluk, Natalia Mazur, Maciej Swierblewski, Manish Chand, Michele Diana, Karol Polom
Surgical Innovation.2022; 29(4): 479. CrossRef
Promising Novel Technique for Tumor Localization in Laparoscopic Colorectal Surgery Using Indocyanine Green-Coated Endoscopic Clips
Dong Woon Lee, Dae Kyung Sohn, Kyung Su Han, Chang Won Hong, Hyoung Chul Park, Jae Hwan Oh
Diseases of the Colon & Rectum.2021; 64(1): e9. CrossRef
Digital dynamic discrimination of primary colorectal cancer using systemic indocyanine green with near-infrared endoscopy
Jeffrey Dalli, Eamon Loughman, Niall Hardy, Anwesha Sarkar, Mohammad Faraz Khan, Haseeb A. Khokhar, Paul Huxel, Donal F. O’Shea, Ronan A. Cahill
Scientific Reports.2021;[Epub] CrossRef
Endoscopic Preoperative Tattooing and Marking in the Gastrointestinal Tract: A Systematic Review of Alternative Methods
Manuel Barberio, Margherita Pizzicannella, Giovanni Guglielmo Laracca, Mahdi Al-Taher, Andrea Spota, Jacques Marescaux, Eric Felli, Michele Diana
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