Ryan ÉJ, Ryan OK, Corrigan N, Ainsworth G, Hilling DE, Vahrmeijer AL et al.
Lancet Gastroenterol Hep 2026; 11: 367-379.
Nine RCTs with 4754 patients were analyzed and demonstrated that ICG use was associated with significantly reduced overall anastomotic leak rate (risk ratio 0.66, 95 per cent confidence interval 0.56 to 0.78, P<0.0001). Significant benefit was observed for left-sided and rectal resections, but not for right-sided resections. Increasing protective effect of ICG was observed with increasing BMI (coefficient -0.0153, -0.0251 to -0.0056, P=0.0020).
Comment: ICG has demonstrated its efficacy in left-sided and rectal anastomoses; the question now is implementation and interpretation.
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