The British journal of surgery
Efficacy of indocyanine green (ICG) angiography in reducing postoperative complications in oesophagectomy: systematic review and meta-analysis
By Dermanis AA, Thompson D, Kamarajah SK and 1 others.
Abstract
Background
Anastomotic leakage after oesophagectomy is common, and associated with significant morbidity and mortality. Indocyanine green (ICG) fluorescence angiography has emerged as a promising intraoperative adjunct for perfusion assessment at the anastomotic site. This study aims to assess the impact of ICG use on anastomotic leakage rates and postoperative outcomes.
Methods
A PRISMA-compliant systematic search of Medline, PubMed, EMBASE, and the Cochrane Library was performed. The primary outcome was anastomotic leakage. Key secondary outcomes were conduit necrosis, mortality, and reoperation; all secondary outcomes were reported. The Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) and Risk of Bias 2 (RoB 2) tools were used for investigating risk of bias. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess certainty of evidence. A random-effects meta-analysis and meta-regression as well as subgroup and sensitivity analyses were performed.