METHODS: A retrospective cohort study involving 556 consecutive patients who underwent colorectal surgery between 2018 and 2023 assessed the utility of routine prophylactic ureteric stenting with adjunctive ICG-FI. Patients with ICG-FI were compared to those without ICG-FI. Demographic data, operative details, and postoperative morbidity were analyzed. Statistical analysis included univariable regression.
RESULTS: Ureteric ICG-FI was used in 312 (56.1%) patients, whereas 43.9% were controls. Both groups were comparable in terms of demographics except for a higher prevalence of prior abdominal surgeries in the ICG-FI group. Although intraoperative visualization was significantly higher in the ICG-FI group (95.3% vs 89.1%; p = 0.011), the incidence of UI was similar between groups (0.3% vs 0.8%; p = 0.585). Postoperative complications were similar between the two groups. Median stent insertion time was longer in the ICG-FI group (32 vs 25 min; p = 0.001).
CONCLUSIONS: Ureteric ICG-FI improved intraoperative visualization of the ureters but was not associated with a reduced UI rate. Median stent insertion time increased with use of ureteric ICG-FI, but total operative time did not. Despite its limitations, this study is the largest of its kind suggesting that ureteric ICG-FI may be a valuable adjunct to facilitate ureteric visualization during colorectal surgery.
方法:一项回顾性队列研究,包括2018年至2023年期间接受结直肠手术的556例连续患者,评估了常规预防性输尿管支架置入术辅助ICG-FI的实用性。将具有ICG-FI的患者与没有ICG-FI的患者进行比较。人口统计数据,操作细节,并对术后发病率进行分析。统计分析包括单变量回归。
结果:312例(56.1%)患者使用输尿管ICG-FI,而43.9%是对照。除了ICG-FI组中先前腹部手术的患病率较高之外,两组在人口统计学方面具有可比性。尽管ICG-FI组的术中可视化明显更高(95.3%vs89.1%;p=0.011),组间UI的发生率相似(0.3%vs0.8%;p=0.585).两组术后并发症情况相似。ICG-FI组的中位支架插入时间更长(32对25分钟;p=0.001)。
结论:输尿管ICG-FI改善了术中输尿管的可视化,但与降低的UI率无关。使用输尿管ICG-FI,支架插入时间中位数增加,但总手术时间没有。尽管有其局限性,这项研究是同类研究中规模最大的,提示输尿管ICG-FI可能是促进结直肠手术中输尿管可视化的有价值的辅助手段.