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Background: This study suggested a novel physiological evaluation of indocyanine-green fluorescence imaging (IFI), and its utility associated with anastomotic leakage/stricture (AL/AS) and prognosis.
Methods: This study focussed on the utility of IFI, comparing IFI + versus IFI- groups (n = 878 vs. 339), optimised by propensity-score matching. After intravenous injection of indocyanine green, maximal perfusion was separately assessed at the vasa recta (VR) and colonic wall (CW), by determining intensities at the VR (VRI) and CW (CWI) and respective time.
Results: Although IFI did not significantly reduce either AL or AS, which occurred approximately 3-fold frequently in patients with lower than higher intensity of VRI. IFI was found as an independent parameter for both disease-free [DFS: hazard ratio (HR) = 0.489; p = 0.002] and overall survival (OS: HR = 0.519; p = 0.021).
Conclusions: Although IFI did not significantly reduce AL/AS, IFI independently reduced 5-year systemic recurrence and increased 5-year DFS and OS.
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http://dx.doi.org/10.1002/rcs.2515 | DOI Listing |
Asian J Endosc Surg
September 2025
Department of Hematology and Oncology, Shizuoka Children's Hospital, Shizuoka, Japan.
Introduction: Total splenectomy in children increases the risk of overwhelming post-splenectomy infection (OPSI). Laparoscopic subtotal splenectomy (LSS) is a technique to preserve splenic function while managing disease burden in pediatric hematologic disorders.
Materials And Surgical Technique: Three children aged 4 to 9 years with juvenile myelomonocytic leukemia (JMML) or hereditary spherocytosis underwent LSS.
Ann Surg Oncol
September 2025
Carle Illinois College of Medicine University of Illinois Urbana-Champaign, 509 W University Ave, Urbana, IL, 61801, USA.
Background: The liver cone unit (Tokyo 2020 terminology) of the peripheral portal vein territory represents the smallest anatomical and functional unit of the liver. While this unit enables anatomical, subsegmental resection, particularly in patients with cirrhosis, the tumor-bearing cone unit can be challenging to identify intraoperatively. PATIENTS AND METHODS: A 58-year-old man with hepatitis C-related cirrhosis (Child-Pugh B) was diagnosed with a subcapsular hepatocellular carcinoma (HCC) in segment 8.
View Article and Find Full Text PDFSurg Endosc
September 2025
Department of Colorectal Surgery, Kansai Medical University, 2-5-1, Shinmachi, Hirakata, Osaka, 573-1010, Japan.
Background: Although the usefulness of indocyanine green fluorescence imaging (ICG-FI) for anastomotic perfusion has been demonstrated in randomized controlled trials, the incidence of anastomotic leakage is not sufficiently low, even in patients using ICG. Because blood flow assessment using ICG is not completely objective, the objectivity of blood flow evaluation is expected to improve by quantification of fluorescence signals. This study aimed to clarify the efficacy of quantitative assessment of blood flow using ICG-FI with the SPY-QP software program in rectal cancer surgery.
View Article and Find Full Text PDFPhotoacoustics
December 2025
Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, United States.
Liposomal carriers, used for site-specific drug delivery, are being investigated for diagnostic approaches by replacing the therapeutic with an imaging contrast agent, exploring potential for selective treatment planning. There remains a critical need to improve assessment of biodistribution, stability, and clearance kinetics of liposomal carriers. This pilot study presents a multimodal approach in which liposome-encapsulated J-aggregated indocyanine green (ICG) dye (Lipo-JICG) is imaged with high spatial resolution using both photoacoustic (PA) imaging, to assess the absorbance characteristics of JICG and monomeric ICG, and cryofluorescence tomography (CFT), to measure ICG fluorescence.
View Article and Find Full Text PDFJ Surg Res
September 2025
Faculty of Medicine, Agha Khan University Hospital, Karachi, Sindh, Pakistan.
Introduction: Anastomotic leakage is a serious complication after colorectal surgery. Indocyanine green fluorescence angiography (ICG-FA) allows real-time perfusion assessment and may reduce leak rates; however, recent larger randomized clinical trials reported conflicting results. This meta-analysis aimed to clarify the effectiveness of ICG-FA in reducing anastomotic leakage and related complications following minimally invasive colorectal surgery.
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