ICG fluorescence imaging in colorectal surgery: a snapshot from the ICRAL study group
Abstract Background Fluorescence-guided visualization is a recently proposed technology in colorectal surgery. Possible uses include evaluating perfusion, navigating lymph nodes and searching for hepatic metastases and peritoneal spread. Despite the absence of high-level evidence, this technique has...
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2021-04-01
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Series: | BMC Surgery |
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Online Access: | https://doi.org/10.1186/s12893-021-01191-6 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gian Luca Baiocchi Gianluca Guercioni Nereo Vettoretto Stefano Scabini Paolo Millo Andrea Muratore Marco Clementi Giuseppe Sica Paolo Delrio Graziano Longo Gabriele Anania Vittoria Barbieri Pietro Amodio Carlo Di Marco Gianandrea Baldazzi Gianluca Garulli Alberto Patriti Felice Pirozzi Raffaele De Luca Stefano Mancini Corrado Pedrazzani Matteo Scaramuzzi Marco Scatizzi Lucio Taglietti Michele Motter Graziano Ceccarelli Mauro Totis Andrea Gennai Diletta Frazzini Gianluca Di Mauro Gabriella Teresa Capolupo Francesco Crafa Pierluigi Marini Giacomo Ruffo Roberto Persiani Felice Borghi Nicolò de Manzini Marco Catarci |
spellingShingle |
Gian Luca Baiocchi Gianluca Guercioni Nereo Vettoretto Stefano Scabini Paolo Millo Andrea Muratore Marco Clementi Giuseppe Sica Paolo Delrio Graziano Longo Gabriele Anania Vittoria Barbieri Pietro Amodio Carlo Di Marco Gianandrea Baldazzi Gianluca Garulli Alberto Patriti Felice Pirozzi Raffaele De Luca Stefano Mancini Corrado Pedrazzani Matteo Scaramuzzi Marco Scatizzi Lucio Taglietti Michele Motter Graziano Ceccarelli Mauro Totis Andrea Gennai Diletta Frazzini Gianluca Di Mauro Gabriella Teresa Capolupo Francesco Crafa Pierluigi Marini Giacomo Ruffo Roberto Persiani Felice Borghi Nicolò de Manzini Marco Catarci ICG fluorescence imaging in colorectal surgery: a snapshot from the ICRAL study group BMC Surgery Colon cancer Rectal cancer Laparoscopy Fluorescence guided surgery ICG |
author_facet |
Gian Luca Baiocchi Gianluca Guercioni Nereo Vettoretto Stefano Scabini Paolo Millo Andrea Muratore Marco Clementi Giuseppe Sica Paolo Delrio Graziano Longo Gabriele Anania Vittoria Barbieri Pietro Amodio Carlo Di Marco Gianandrea Baldazzi Gianluca Garulli Alberto Patriti Felice Pirozzi Raffaele De Luca Stefano Mancini Corrado Pedrazzani Matteo Scaramuzzi Marco Scatizzi Lucio Taglietti Michele Motter Graziano Ceccarelli Mauro Totis Andrea Gennai Diletta Frazzini Gianluca Di Mauro Gabriella Teresa Capolupo Francesco Crafa Pierluigi Marini Giacomo Ruffo Roberto Persiani Felice Borghi Nicolò de Manzini Marco Catarci |
author_sort |
Gian Luca Baiocchi |
title |
ICG fluorescence imaging in colorectal surgery: a snapshot from the ICRAL study group |
title_short |
ICG fluorescence imaging in colorectal surgery: a snapshot from the ICRAL study group |
title_full |
ICG fluorescence imaging in colorectal surgery: a snapshot from the ICRAL study group |
title_fullStr |
ICG fluorescence imaging in colorectal surgery: a snapshot from the ICRAL study group |
title_full_unstemmed |
ICG fluorescence imaging in colorectal surgery: a snapshot from the ICRAL study group |
title_sort |
icg fluorescence imaging in colorectal surgery: a snapshot from the icral study group |
publisher |
BMC |
series |
BMC Surgery |
issn |
1471-2482 |
publishDate |
2021-04-01 |
description |
Abstract Background Fluorescence-guided visualization is a recently proposed technology in colorectal surgery. Possible uses include evaluating perfusion, navigating lymph nodes and searching for hepatic metastases and peritoneal spread. Despite the absence of high-level evidence, this technique has gained considerable popularity among colorectal surgeons due to its significant reliability, safety, ease of use and relatively low cost. However, the actual use of this technique in daily clinical practice has not been reported to date. Methods This survey was conducted on April 2020 among 44 centers dealing with colorectal diseases and participating in the Italian ColoRectal Anastomotic Leakage (iCral) study group. Surgeons were approximately equally divided based on geographical criteria from multiple Italian regions, with a large proportion based in public (89.1%) and nonacademic (75.7%) centers. They were invited to answer an online survey to snapshot their current behaviors regarding the use of fluorescence-guided visualization in colorectal surgery. Questions regarding technological availability, indications and techniques, personal approaches and feelings were collected in a 23-item questionnaire. Results Questionnaire replies were received from 37 institutions and partially answered by 8, as this latter group of centers do not implement fluorescence technology (21.6%). Out of the remaining 29 centers (78,4%), fluorescence is utilized in all laparoscopic colorectal resections by 72.4% of surgeons and only for selected cases by the remaining 27.6%, while 62.1% of respondents do not use fluorescence in open surgery (unless the perfusion is macroscopically uncertain with the naked eye, in which case 41.4% of them do). The survey also suggests that there is no agreement on dilution, dosing and timing, as many different practices are adopted based on personal judgment. Only approximately half of the surgeons reported a reduced leak rate with fluorescence perfusion assessment, but 65.5% of them strongly believe that this technique will become a minimum requirement for colorectal surgery in the future. Conclusion The survey confirms that fluorescence is becoming a widely used technique in colorectal surgery. However, both the indications and methods still vary considerably; furthermore, the surgeons' perceptions of the results are insufficient to consider this technology essential. This survey emphasizes the need for further research to reach recommendations based on solid scientific evidence. |
topic |
Colon cancer Rectal cancer Laparoscopy Fluorescence guided surgery ICG |
url |
https://doi.org/10.1186/s12893-021-01191-6 |
work_keys_str_mv |
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doaj-752e0efd65ea4dc198d9ff512fce157a2021-04-11T11:21:29ZengBMCBMC Surgery1471-24822021-04-012111710.1186/s12893-021-01191-6ICG fluorescence imaging in colorectal surgery: a snapshot from the ICRAL study groupGian Luca Baiocchi0Gianluca Guercioni1Nereo Vettoretto2Stefano Scabini3Paolo Millo4Andrea Muratore5Marco Clementi6Giuseppe Sica7Paolo Delrio8Graziano Longo9Gabriele Anania10Vittoria Barbieri11Pietro Amodio12Carlo Di Marco13Gianandrea Baldazzi14Gianluca Garulli15Alberto Patriti16Felice Pirozzi17Raffaele De Luca18Stefano Mancini19Corrado Pedrazzani20Matteo Scaramuzzi21Marco Scatizzi22Lucio Taglietti23Michele Motter24Graziano Ceccarelli25Mauro Totis26Andrea Gennai27Diletta Frazzini28Gianluca Di Mauro29Gabriella Teresa Capolupo30Francesco Crafa31Pierluigi Marini32Giacomo Ruffo33Roberto Persiani34Felice Borghi35Nicolò de Manzini36Marco Catarci37Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali CiviliGeneral Surgery Unit, CG Mazzoni HospitalGeneral Surgery Unit, ASST Spedali CiviliGeneral & Oncologic Surgery Unit, National Cancer Center “San Martino”General Surgery Unit, Aosta Regional HospitalGeneral Surgery Unit, Agnelli HospitalGeneral Surgery Unit, University HospitalGeneral Surgery Unit, Policlinico Tor Vergata University HospitalColorectal Surgical Oncology Unit, IRCCS G. Pascale FoundationGeneral Surgery Unit, Policlinico CasilinoGeneral Surgery Unit, University HospitalGeneral Surgery Unit, Cardinale G. Panico HospitalGeneral Surgery Unit, Belcolle HospitalGeneral Surgery Unit, Conegliano Hospital (TV) ULSS2 Marca TrevigianaGeneral Surgery Unit, ASST Nord HospitalGeneral Surgery Unit, Infermi HospitalGeneral Surgery Unit, Marche Nord HospitalGeneral Surgery Unit, ASL Napoli2 HospitalGeneral Surgery Unit, IRCCS Istituto Giovanni Paolo IIGeneral & Oncologic Surgery Unit, San Filippo Neri HospitalGeneral Surgery Unit, University HospitalGeneral Surgery Unit, IRCCS Casa Sollievo Della SofferenzaGeneral Surgery Unit, Santa Maria Annunziata HospitalGeneral Surgery Unit, ASST Valle CamonicaGeneral Surgery Unit 1, Santa Chiara HospitalGeneral Surgery Unit, San Giovanni Battista HospitalGeneral Surgery Unit, San Gerardo HospitalGeneral Surgery Unit, Sant’Andrea HospitalGeneral Surgery Unit, Ospedale Civile Di PescaraGeneral Surgery Unit, Ospedale Di RagusaColorectal Surgery Unit, Policlinico Universitario Campus Bio MedicoGeneral & Oncologic Surgery Unit, San Giuseppe Moscati HospitalGeneral Surgery Unit, San Camillo HospitalGeneral Surgery Unit, IRCCS Sacro Cuore Don Calabria HospitalMinimally Invasive Oncologic Surgery Unit, IRCCS Policlinico Gemelli FoundationGeneral Surgery Unit, Santa Croce E Carle HospitalGeneral Surgery Unit, University HospitalGeneral Surgery Unit, CG Mazzoni HospitalAbstract Background Fluorescence-guided visualization is a recently proposed technology in colorectal surgery. Possible uses include evaluating perfusion, navigating lymph nodes and searching for hepatic metastases and peritoneal spread. Despite the absence of high-level evidence, this technique has gained considerable popularity among colorectal surgeons due to its significant reliability, safety, ease of use and relatively low cost. However, the actual use of this technique in daily clinical practice has not been reported to date. Methods This survey was conducted on April 2020 among 44 centers dealing with colorectal diseases and participating in the Italian ColoRectal Anastomotic Leakage (iCral) study group. Surgeons were approximately equally divided based on geographical criteria from multiple Italian regions, with a large proportion based in public (89.1%) and nonacademic (75.7%) centers. They were invited to answer an online survey to snapshot their current behaviors regarding the use of fluorescence-guided visualization in colorectal surgery. Questions regarding technological availability, indications and techniques, personal approaches and feelings were collected in a 23-item questionnaire. Results Questionnaire replies were received from 37 institutions and partially answered by 8, as this latter group of centers do not implement fluorescence technology (21.6%). Out of the remaining 29 centers (78,4%), fluorescence is utilized in all laparoscopic colorectal resections by 72.4% of surgeons and only for selected cases by the remaining 27.6%, while 62.1% of respondents do not use fluorescence in open surgery (unless the perfusion is macroscopically uncertain with the naked eye, in which case 41.4% of them do). The survey also suggests that there is no agreement on dilution, dosing and timing, as many different practices are adopted based on personal judgment. Only approximately half of the surgeons reported a reduced leak rate with fluorescence perfusion assessment, but 65.5% of them strongly believe that this technique will become a minimum requirement for colorectal surgery in the future. Conclusion The survey confirms that fluorescence is becoming a widely used technique in colorectal surgery. However, both the indications and methods still vary considerably; furthermore, the surgeons' perceptions of the results are insufficient to consider this technology essential. This survey emphasizes the need for further research to reach recommendations based on solid scientific evidence.https://doi.org/10.1186/s12893-021-01191-6Colon cancerRectal cancerLaparoscopyFluorescence guided surgeryICG |