Indocyanine green fluorescence angiography for prevention of anastomotic leak in colorectal surgery: a graded systematic review and meta-analysis with trial sequential analysis of randomized controlled trials.
Tech ColoproctolSep 23, 2026 (epub)
Mahmoud Albashier, Mohamed Al Sayed, Hashem Altabbaa et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy of indocyanine green fluorescence angiography (ICG-FA) in preventing anastomotic leaks (AL) in colorectal surgery, analyzing data from eight randomized controlled trials involving 4712 patients. The study found that ICG-FA significantly reduced overall AL compared to conventional assessment, with a risk ratio of 0.68 (95% CI 0.58-0.81).
Key findings
- ICG-FA reduced overall anastomotic leaks with a risk ratio of 0.68 (95% CI 0.58-0.81).
- The absolute risk reduction was 3.6%, leading to a number needed to treat of approximately 24.
- Benefits of ICG-FA were more pronounced for left-sided anastomoses and lower-grade leaks.
- Overall complications showed a small relative reduction, but evidence size was insufficient.
Why it matters
Anastomotic leaks are a significant complication following colorectal surgery, leading to increased morbidity. The use of ICG-FA may enhance intraoperative decision-making and improve patient outcomes by optimizing perfusion assessment.