'Video Correspondence': Full-Thickness rectal advancement flap for complex fistula-in-ano using Indocyanine Green Fluorescence.

Autores de IIS La Fe

• Vicent Primo I Romaguera

  Autor

• Jorge Sancho Muriel

  Autor

• Hanna Barbara Cholewa

  Autor

Participantes ajenos a IIS La Fe

• López DP
• Alvarez-Sarrado, Eduardo
• Millan, Monica

Grupos

• Cirugía digestiva y Cuidados perioperatorios

Abstract

INTRODUCTION: High transsphincteric fistulas are considered complex because of the risk of fecal incontinence after reparation. Rectal advancement flap is an attractive sphincter-sparing procedure indicated in complex perianal fistula, however perfusion defects could lead to suture failure and fistula recurrence. The use of Fluorescence Angiography with ICG (Indocyanine Green) could be useful to assess correct flap perfusion. OBJECTIVES: Perfusion of the rectal flap could be tested by using ICG. METHODS: We show a step-by-step Full-Thickness rectal advancement video and how ICG was used to assess the flap perfusion. CONCLUSION: The use of a broad-based flap is recommended to ensure adequate blood supply and ICG could provide greater safety during surgery.

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Keywords

• indocyanine green; loperamide; adult; case report; clinical article; clinical effectiveness; clinical feature; complex fistula in ano; digestive system fistula; female; flatus incontinence; follow up; full thickness rectal advancement flap; human; Letter; liquid diet; postoperative care; tissue flap; treatment outcome; fluorescence; rectum; rectum fistula; surgical flaps; Fluorescence; Humans; Indocyanine Green; Rectal Fistula; Rectum; Surgical Flaps; Treatment Outcome