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<p>Anastomotic leakage remains one of the most significant complications of colorectal surgery. Because adequate blood supply is a&#xa0;key prerequisite for anastomotic healing, near-infrared fluorescence angiography with indocyanine green (ICG) has become an adjunct to conventional visual assessment. The current review summarizes the pharmacological and physical principles, dosing and timing, practical workflow, and interpretation of fluorescence patterns (intensity, homogeneity and inflow time) as well as limitations and sources of error. Randomized controlled trials (RCTs) report heterogeneous effects: while selected studies demonstrate lower leak rates, RCT-based meta-analyses suggest a&#xa0;moderate overall benefit, particularly in left-sided resections and/or low anastomoses. Contraindications, documentation of strategy changes, and future developments are discussed.</p>

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Indocyaningrün zur Perfusionsanalyse kolorektaler Anastomosen

  • 期刊论文

  • 发表日期：

    2026年5月27日

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  • W. Kneist,
  • A. Galil,
  • F. Hüttl,
  • B. Urban-Klein,
  • E. L. Wisotzky,
  • S. Kray

摘要

Anastomotic leakage remains one of the most significant complications of colorectal surgery. Because adequate blood supply is a key prerequisite for anastomotic healing, near-infrared fluorescence angiography with indocyanine green (ICG) has become an adjunct to conventional visual assessment. The current review summarizes the pharmacological and physical principles, dosing and timing, practical workflow, and interpretation of fluorescence patterns (intensity, homogeneity and inflow time) as well as limitations and sources of error. Randomized controlled trials (RCTs) report heterogeneous effects: while selected studies demonstrate lower leak rates, RCT-based meta-analyses suggest a moderate overall benefit, particularly in left-sided resections and/or low anastomoses. Contraindications, documentation of strategy changes, and future developments are discussed.