Current applications of indocyanine green fluorescence in colorectal surgery: a narrative review

Background and Objective: Colorectal surgical operations are linked with a substantial risk of morbidity and mortality. Indocyanine green (ICG) dye has been proposed to potentially reduce complications, particularly anastomotic failures, by allowing surgeons to assess bowel perfusion and make perceived necessary adjustments during surgery; other applications are being investigated and implementation is ongoing; a review of the current state is presented here. Methods: A systematic search of the MEDLINE and Embase databases for literature on ICG dye usage in colorectal surgery published up to March 30, 2023 was used to perform this narrative review. A Google Scholar scoping search was also conducted to locate relevant grey material. Key Content and Findings: According to qualitative evaluation, the use of ICG dye alters the rate of anastomotic leakage (AL), although the overall impact of the effect is modest. The quantitative measurement of the ICG dye resulted in a greater magnitude of influence; however, additional research is required to demonstrate the results' statistical significance. This approach has been utilized to detect positive sentinel lymph nodes in patients with primary colorectal cancer. Ultimately, according to existing studies using ICG dye to pinpoint lesions resulted in accurate identification can be obtained in 81% of cases. Conclusions: The use of ICG dye in colorectal surgery appears to be a promising tool for qualitative and quantitative assessment of perfusion, with the goal of improving results related to ALs, accurate tumour labelling and sentinel lymph node identification, lymphatic drainage mapping, and ureter identification. Further study in this area has the potential to enhance overall patient outcomes for colorectal patients substantially.