Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;35(12):7142-7153.
doi: 10.1007/s00464-020-08234-8. Epub 2021 Jan 25.

Fluorescence-based bowel anastomosis perfusion evaluation: results from the IHU-IRCAD-EAES EURO-FIGS registry

Andrea Spota #  1   2 , Mahdi Al-Taher #  3 , Eric Felli  3 , Salvador Morales Conde  4   5 , Ivano Dal Dosso  6 , Gianluigi Moretto  7 , Giuseppe Spinoglio  8 , Gianluca Baiocchi  9 , Ramon Vilallonga  10 , Harmony Impellizzeri  7 , Gonzalo P Martin-Martin  11 , Lorenzo Casali  12 , Christian Franzini  12 , Marta Silvestri  13 , Nicolò de Manzini  13 , Maurizio Castagnola  14 , Marco Filauro  14 , Davide Cosola  13 , Catalin Copaescu  15 , Giovanni Maria Garbarino  16 , Antonio Pesce  17 , Marcello Calabrò  18 , Paola de Nardi  19 , Gabriele Anania  20 , Thomas Carus  21 , Luigi Boni  22 , Alessandro Patané  23 , Caterina Santi  12 , Alend Saadi  24 , Alessio Rollo  12 , Roland Chautems  24 , José Noguera  25 , Jan Grosek  26 , Giancarlo D'Ambrosio  27 , Carlos Marques Ferreira  28 , Gregor Norcic  26 , Giuseppe Navarra  29 , Pietro Riva  30 , Silvia Quaresima  27 , Alessandro Paganini  27 , Nunzio Rosso  31 , Paolo De Paolis  32 , Andrea Balla  27 , Marc Olivier Sauvain  24 , Eleftherios Gialamas  24 , Giorgio Bianchi  12 , Gaetano La Greca  33 , Carlo Castoro  30 , Andrea Picchetto  27 , Alessandro Franchello  32 , Luciano Tartamella  12 , Robert Juvan  26 , Orestis Ioannidis  34 , Jurij Ales Kosir  26 , Emilio Bertani  35 , Laurents Stassen  36 , Jacques Marescaux  1 , Michele Diana  37   38   39   40
Affiliations
Free article

Fluorescence-based bowel anastomosis perfusion evaluation: results from the IHU-IRCAD-EAES EURO-FIGS registry

Andrea Spota et al. Surg Endosc. 2021 Dec.
Free article

Abstract

Background: Anastomotic leakage (AL) is one of the dreaded complications following surgery in the digestive tract. Near-infrared fluorescence (NIRF) imaging is a means to intraoperatively visualize anastomotic perfusion, facilitating fluorescence image-guided surgery (FIGS) with the purpose to reduce the incidence of AL. The aim of this study was to analyze the current practices and results of NIRF imaging of the anastomosis in digestive tract surgery through the EURO-FIGS registry.

Methods: Analysis of data prospectively collected by the registry members provided patient and procedural data along with the ICG dose, timing, and consequences of NIRF imaging. Among the included upper-GI, colorectal, and bariatric surgeries, subgroup analysis was performed to identify risk factors associated with complications.

Results: A total of 1240 patients were included in the study. The included patients, 74.8% of whom were operated on for cancer, originated from 8 European countries and 30 hospitals. A total of 54 surgeons performed the procedures. In 83.8% of cases, a pre-anastomotic ICG dose was administered, and in 60.1% of cases, a post-anastomotic ICG dose was administered. A significant difference (p < 0.001) was found in the ICG dose given in the four pathology groups registered (range: 0.013-0.89 mg/kg) and a significant (p < 0.001) negative correlation was found between the ICG dose and BMI. In 27.3% of the procedures, the choice of the anastomotic level was guided by means of NIRF imaging which means that in these cases NIRF imaging changed the level of anastomosis which was first decided based on visual findings in conventional white light imaging. In 98.7% of the procedures, the use of ICG partly or strongly provided a sense of confidence about the anastomosis. A total of 133 complications occurred, without any statistical significance in the incidence of complications in the anastomoses, whether they were ICG-guided or not.

Conclusion: The EURO-FIGS registry provides an insight into the current clinical practice across Europe with respect to NIRF imaging of anastomotic perfusion during digestive tract surgery.

Keywords: Fluorescence-guided surgery; Image-guided surgery; Near-infrared fluorescence imaging; Registry.

PubMed Disclaimer

References

    1. Kassis ES, Kosinski AS, Ross P Jr, Koppes KE, Donahue JM, Daniel VC (2013) Predictors of anastomotic leak after esophagectomy: an analysis of the society of thoracic surgeons general thoracic database. Ann Thorac Surg 96(6):1919–1926 - DOI
    1. Biere SS, Maas KW, Cuesta MA, van der Peet DL (2011) Cervical or thoracic anastomosis after esophagectomy for cancer: a systematic review and meta-analysis. Dig Surg 28(1):29–35 - DOI
    1. Orringer MB, Marshall B, Chang AC, Lee J, Pickens A, Lau CL. Two thousand transhiatal esophagectomies: changing trends, lessons learned. Ann Surg. 2007;246(3):363–72; discussion 72–4.
    1. Lang H, Piso P, Stukenborg C, Raab R, Jahne J (2000) Management and results of proximal anastomotic leaks in a series of 1114 total gastrectomies for gastric carcinoma. Eur J Surg Oncol 26(2):168–171 - DOI
    1. Haga Y, Wada Y, Takeuchi H, Ikejiri K, Ikenaga M (2011) Prediction of anastomotic leak and its prognosis in digestive surgery. World J Surg 35(4):716–722 - DOI

Publication types

Substances

LinkOut - more resources