Massimo Pezzatini
Azienda Ospedaliera Regina Apostolorum, Italy
Title: Indocyanine green fl uorescence angiography: A new ERAS item
Biography
Biography: Massimo Pezzatini
Abstract
ERAS protocol and Indocyanine Green Fluorescence Angiography (ICG-FA) represent the new surgical revolution minimizing complications and shortening recovery time in colorectal surgery. As of today, no studies have been published in the literature evaluating the impact of the ICG-FA in the ERAS protocol for the patients suitable for colorectal surgery. Th e aim of our study was to assess whether the systematic evaluation of intestinal perfusion by ICG-FA could improve patients outcomes when managed with ERAS perioperative protocol, thus reducing surgical complication rate. Th is is a retrospective case-control study. From March 2014 to April 2017, 182 patients underwent laparoscopic colorectal surgery for benign and malignant diseases. All the patients were enrolled in ERAS protocol. Two groups were created: Group-A comprehended 107 patients managed within the ERAS pathway only and Group-B comprehended 75 patients managed as well as with ERAS pathway plus the intraoperative assessment of intestinal perfusion with ICG-FA. Two board-certifi ed laparoscopic colorectal surgeons jointly performed all procedures. Six (5.6%) clinically relevant Anastomotic Leakages (AL) occurred in Group-A, while there was none in Group-B, demonstrating that ICG-FA integrated in the ERAS protocol can lead to a statistically signifi cant reduction of the AL. Mean operative time between the two groups was not statistically signifi cant. In fi ve cases (6.6%), the demarcation line set by the fl uorescence made the surgeon change the resection line previously marked. Th e prevalence of all other complications did not diff er statistically between the two groups. Our study confi rms that combination between ICG and ERAS protocol is feasible and safe and reduces the anastomotic leakage, possibly leading to consider ICG-FA as a new ERAS item.