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Indocyanine Green in Esophageal Surgery, a Systematic Review and Meta Analysis

Kandace Kichler, MD, Joshua Parreco, MD, Srinivas Kaza, MD. University of Miami Palm Beach

INTRODUCTION: Florescence angiography with indocyanine green (ICG) has been approved for clinical use since the 1950s. The purpose of this study was to determine the predictive value of fluorescence angiography with ICG for anastomotic leaks after esophagectomy.

METHODS AND PROCEDURES: A systematic review and meta analysis was performed for studies evaluating florescence angiography using ICG with esophagectomy to predict postoperative anastomotic leaks.

RESULTS: Sixteen studies were included in the systematic review including 490 patients undergoing esophagectomy and ICG evaluation. Sufficient data for meta analysis was found in fourteen studies with 424 patients. There were 56 (13.2%) leaks reported and the pooled sensitivity for detecting leaks was 0.55 (95% CI 0.23 to 0.81) and the pooled specificity was 0.94 (95% CI 0.84 to 0.99). The pooled log diagnostic odds ratio (DOR) was 3.16 (95% CI 1.44 to 5.16) and the summary receiver operating characteristic (ROC) area under the curve (AUC) was 0.85 (95% CI 0.53 to 0.98).

CONCLUSION(S): Florescence angiography with indocyanine green is a useful test to predict, and potentially prevent, postoperative anastomotic leaks after esophagectomy.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 77691

Program Number: P384

Presentation Session: Poster (Non CME)

Presentation Type: Poster

287

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