New Advances in Reducing Anastomotic Leaks in Rectal Cancer Surgery

A new study found that integrating intraoperative indocyanine green (ICG) fluorescence angiography with targeted transanal tube placement substantially lowers anastomotic leak rates after rectal cancer resection.

A retrospective analysis of consecutive patients undergoing rectal resection with primary anastomosis evaluated intraoperative perfusion assessment and postoperative outcomes, with the primary endpoint set as clinical anastomotic leakage. In this cohort, perfusion was assessed intraoperatively using ICG fluorescence angiography, and patients were grouped by postoperative transanal tube use versus no tube.

The investigators found an absolute reduction in clinical leak rates from about 18% in the non-tube group to roughly 5% in the tube group (p=0.02), supporting a substantial association between the combined approach and lower leakage and suggesting that perfusion confirmation plus a mechanical adjunct can reduce intraoperative uncertainty about anastomotic integrity.