• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Impact of Routine Fluorescence Angiography in Colorectal Surgery

Deborah S Keller, MS, MD1, Irlna Tantchou, MD2, Matthew Schultzel, DO2, Juan R Flores-Gonzalez, MD1, Sergio Ibarra, MD1, Eric M Haas, MD, FACS, FASCRS3. 1Colorectal Surgical Associates, 2University of Texas Medical Center at Houston, 3Colorectal Surgical Associates; Houston Methodist Hospital; University of Texas Medical School at Houston

Background: Anastomotic leaks represent a major problem in colorectal surgery. In addition to the clinical morbidity and mortality, anastomotic leaks dramatically increase the length of stay, readmission rates, and total costs of care. Fluorescence Angiography allows real-time visualization of bowel perfusion during colorectal resection and may lead to a decreased incidence of anastomotic leak. The utility and feasibility of intra-operative perfusion assessment has been demonstrated in low anterior resection for malignant disease. However, no previous study has assessed the value for routine use. Our goal was to evaluate the intraoperative and postoperative outcomes using Fluorescence Angiography in benign and malignant abdominal resections.

Methods: Fluorescence Angiography was utilized in a prospective series of minimally invasive benign and malignant colorectal procedures from 8/1/14-8/1/15. Right-sided and small bowel resections, and those receiving neoadjuvant chemoradiation were excluded for respective low and high anastomotic leak rates. Demographic, perioperative, and postoperative outcomes variables were analyzed. The main outcome measures were the impact of fluorescence angiography on the planned resection site, the rate of stoma creation, and postoperative complications.

Results: 70 patients were evaluated. The cohort had 41 (58.57%) men, a mean age of 55.77 years (SD14.21), and mean BMI of 27.25 kg/m2 (4.98). The main diagnosis was diverticulitis (n=23, 32.86%), and the primary procedure performed a low anterior resection (n=29, 41.43%). Procedures were performed through multiport laparoscopic (n=14), robotic-assisted laparoscopic (n=6), and single-incision laparoscopic approaches (n=50). Nine patients had changes in resection margin from poor perfusion on fluorescence angiography- all appeared grossly pink and viable. After revision, all were well perfused on repeat study. Operative times were similar between the revised and unrevised groups (240.49 min [SD86.79] vs. 236.39 [SD87.40], respectively). Three unplanned stomas were created after change in resection margin. Of the 70 patients, only 1 had a postoperative anastomotic dehiscence/ pelvic abscess. This patient had intraoperative revision of the planned anastomotic site, then readmission for percutaneous drainage. There was 1 other readmission in the cohort (dehydration), 1 reoperation (bleeding), and no mortalities.

Conclusions:  Fluorescence angiography showed value in perfusion assessment for a variety of benign and malignant procedures. Almost 13% of patient had unexpected poor perfusion, with great potential advantages for preventing an anastomotic leak. Patients with a change in anastomotic site may require closer postoperative attention. Fluorescence angiography deserves further study for clinical and financial advantages in routine use for colorectal procedures.

95

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2016 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons