Near-infrared indocyanine green angiography showed a positive effect in evaluating bowel perfusion during emergency operations across 11 studies (358 patients), though one study noted limitations.
Systematic Review (n=358)
Does near-infrared indocyanine green angiography improve the evaluation of bowel perfusion in patients undergoing emergency intestinal surgery?
NIR-ICG angiography shows promise as a tool for assessing bowel perfusion in emergency intestinal surgery, but requires standardization and validation in randomized trials.
Assessing bowel perfusion in emergency intestinal surgery can prove challenging even for experienced surgeons. The necessity of a technological tool assisting clinicians is undisputed. Near-infrared indocyanine green (NIR-ICG) angiography has been increasingly used in elective colorectal surgery to evaluate intestinal perfusion with promising results. This review aims to answer whether a similar outcome can be observed in acute cases of bowel ischemia. We conducted online research of the literature using keywords such as "indocyanine green", "bowel", "emergency" and "ischemia", to identify articles concerning the use of ICG-angiography in evaluating bowel perfusion during emergency operations. PubMed was the primary database. 11 articles were included in this systematic review with a total of 358 patients. Most papers showed a positive effect after using NIR-ICG-angiography, whereas one study indicated the limitations of the method by exhibiting increased reoperation and mortality rates. Moreover, a significant variation in indocyanine green (ICG) dose and fluorescence identification systems was observed. NIR-ICG-angiography has the potential to become a fundamental tool in emergency intestinal operations. Nevertheless, additional research, especially high-quality, randomized studies, as well as quantification techniques are still needed to support these preliminary observations.
Christofi et al. (Sat,) conducted a systematic review in Acute bowel ischemia in emergency surgery (n=358). Near-infrared indocyanine green (NIR-ICG) angiography was evaluated on Bowel perfusion evaluation. Near-infrared indocyanine green angiography showed a positive effect in evaluating bowel perfusion during emergency operations across 11 studies (358 patients), though one study noted limitations.