Indocyanine Green ICG in Segmentary Resection in Colo-rectal Surgery is Usefull to Decrease Leak Threshold: A Paralel Retrospetive Cohort Study

This is a parallel monocentric, retrospective cohort study observing consecutive series of patients underwent colo-rectal surgery at our institution between 1 January 2017 and 31 July 2023.

The primary endpoint of the study is Anastomotic Leak (AL) at 30 days while secondary endpoints are post-operative morbidity Clavien-Dindo score ≥III within 30 days from surgery including readmission and redo-surgery, harvested nodes for patients with neoplastic disease, Surgical Site Infection, rate of laparoscopic surgical procedure and rate of protection stoma.

Sex, Body Mass Index, smoking, diabetes mellitus, cardiovascular disease, tumor stage according to AJJC 8th edition will be considered confounding factor for onset of AL.

Patients electronic database will be collected from extraction of medical record in operating log and every digital medical record will be scanned including peri-operative outcomes and 30 days post-operative follow-up from post-operative visit, eventually readmission in emergency department or any other specialistic wards of our local health institution according to following inclusion criteria: elective setting of surgery, segmentary left colon surgery: splenic colic resection, transverse colic resection and left colectomy defined as left hemicolectomy with low mesenteric artery-ligation and sigmoidectomy even for benign or malign pathology, at least 30 days of post-operative follow-up available from medical documentation, primary colo-colic or colo-rectal anastomosis with or without preventing ostomy and adult age.

Exclusion criteria are terminal colonic stoma without anastomosis creation after demolitive step, extended transverse right hemicolectomy, left hemicolectomy with high vascular ligation, associated bowel or another splanchnic resection (i.e. neoplastic infiltration), previous colic surgery, synchronous neoplasm, not reporting in operating form details about vascular ligation, lack in reporting in medical records of primary outcomes, stage IV cancer, ASA IV, less than 18 years old and emergency setting.