EP822 - Indocyanine green fluorescence imaging in ileal pouch-anal anastomosis: A systematic review of the literature

Monday, May 11, 2026

10:31 AM - 10:36 AM ET

ePoster Presenter(s)

Zoe Garoufalia, MD,PhD (she/her/hers)

Colorectal Surgeon
Hygeia Hospital
Marousi, Attiki, Greece

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no relevant financial relationships.

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Author(s)

EP

Eleni - Aigli Politaki, MD

General Surgery Resident
Hygeia Hospital - Node Institute
Athens, Attiki, Greece

Disclosure information not submitted.
SM

Sofoklis Mavrantonis, MD

General Surgery Resident
Gloucestershire Hospitals NHS Foundation Trust
London, England, United Kingdom

Disclosure information not submitted.
PA

Paraskevi Alexakou, MD

Consultant surgeon
Hygeia hospital - Node Institute
Athens, Attiki, Greece

Disclosure information not submitted.

Senior Author(s)

CM

Constantine Mavrantonis, MD

Consultant Colorectal Surgeon
Hygeia Hospital - Node Institute
Athens, Attiki, Greece

Disclosure information not submitted.

Purpose/Background: Anastomotic leak following ileal pouch-anal anastomosis (IPAA) can reach up to 20% and remains a major cause of long-term pouch failure. Indocyanine green (ICG) angiography facilitates assessment of perfusion especially when elongating maneuvers are utilised. Evidence regarding its use in IPAA construction is emerging but remains limited.

Methods/Interventions: Our aim was to systematically review the current literature on the use of ICG imaging during IPAA, focusing on feasibility, safety, intraoperative decision-making, and anastomotic outcomes and reporting according to PRISMA guidelines

Results/Outcomes: 6 studies were included in this review, comprising of 134 patients. 4 studies were originated from the Netherlands and, 1 from Italy and 1 from Germany, 3 retrospective, 2 prospective and 1 case control. The mean reported ICG dose was 0.1 mg/kg IV and the overall leak ranged from 0-16%; generally lower than historical controls. Intraoperative change rate: up to 19%. No adverse events reported with ICG administration

Conclusion/Discussion: ICG angiography is a safe, easy to use and potentially valuable tool for perfusion assessment during IPAA construction. Early evidence suggests a reduction in leak rates and improved intraoperative decision-making. Prospective randomized trials are needed to establish standardized use and assess its impact on pouch outcomes.