JOURNAL OF THE CZECH PEDIATRIC SOCIETY AND THE SLOVAK PEDIATRIC SOCIETY

Čes-slov Pediat 2025, 80(6):299-303 | DOI: 10.55095/CSPediatrie2025/013

Indocyanine green fluorescence angiography in pediatric non-oncological gastrointestinal surgery: possibilities and perspectives

Dmytro Klymenko1, Ivana Slivová1, Lubomír Martínek2, Peter Ihnát2
1 Centrum dětské chirurgie a traumatologie, Fakultní nemocnice Ostrava
2 Chirurgická klinika, Fakultní nemocnice Ostrava

Fluorescence angiography with indocyanine green (ICG) represents a novel technology that has the potential to markedly enhance surgical outcomes, particularly in the context of gastrointestinal abdominal surgery. The available data suggest that ICG may also be advantageously used in paediatric patients undergoing gastrointestinal procedures,

including surgery for necrotising enterocolitis, oesophageal atresia or gastrointestinal reconstruction.

The pharmacological properties of ICG include rapid elimination, safety with proper dosing and minimal risk of adverse effects. Nevertheless, the paucity of data pertaining to the utilisation of ICG in paediatric gastrointestinal surgery thus far indicates a

necessity for further research aimed at establishing standardised dosing regimens and indications. This article provides an overview of the technical and pharmacological aspects of ICG, its clinical application, and the prospects for further development of perioperative fluorescence angiography.

Keywords: fluorescence angiography, indocyanine green, intestinal anastomosis, dehiscence of anastomosis, necrotizing enterocolitis, anorectal malformation, Hirschsprung's disease

Received: January 4, 2025; Revised: March 26, 2025; Accepted: March 27, 2025; Published: August 1, 2025  Show citation

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Klymenko D, Slivová I, Martínek L, Ihnát P. Indocyanine green fluorescence angiography in pediatric non-oncological gastrointestinal surgery: possibilities and perspectives. Ces-slov Pediat. 2025;80(6):299-303. doi: 10.55095/CSPediatrie2025/013.
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    References

    1. . Urbanavičius L, Pattyn P, Van de Putte D, Venskutonis D. How to assess intestinal viability during surgery: a review of techniques. World J. Gastrointest. Surg 2011; 3: 59. Go to original source... Go to PubMed...
    2. . Reinhart MB, Huntington CR, Blair LJ, et al. Indocyanine green: historical context, current applications, and future considerations. Surg Innov 2016; 23: 166-175. Go to original source... Go to PubMed...
    3. . Cherrick GR, Stein SW, Leevy CM, Davidson CS. Indocyanine green: observations on its physical properties, plasma decay, and hepatic extraction. J Clin Investig 1960; 39: 592-600. Go to original source... Go to PubMed...
    4. . Ris F, Hompes R, Cunningham C, et al. Near-infrared (NIR) perfusion angiography in minimally invasive colorectal surgery. Surg Endosc 2014; 28(7): 2221-6. Go to original source... Go to PubMed...
    5. . Martínek L, Bergamaschi R, Hoch J. Intraoperative verification of colorectal anastomotic integrity. Rozhl Chir 2015; 94: 185-188.
    6. . Polom K, Murawa D, Rho YS, et al. Current trends and emerging future of indocyanine green usage in surgery and oncology: a literature review. Cancer 2011; 117(21): 4812-22. Go to original source... Go to PubMed...
    7. . Luo S, Zhang E, Su Y, et al. A review of NIR dyes in cancer targeting and imaging. Biomaterials 2011; 32(29): 7127-38. Go to original source... Go to PubMed...
    8. . Le-Nguyen A, Bourque CJ, Trudeau MO, et al. Indocyanine green fluorescence angiography in pediatric intestinal resections: a first prospective mixed methods clinical trial. J Pediatr Surg 2023; 58: 82-88. Go to original source... Go to PubMed...
    9. . Diana M. Enabling precision digestive surgery with fluorescence imaging. Transl Gastroenterol Hepatol 2017; 2: 97. Go to original source... Go to PubMed...
    10. . Boni L, David G, Mangano A, et al. Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery. Surg Endosc 2015; 29: 2046-2055. Go to original source... Go to PubMed...
    11. . Mizrahi I, Wexner SD. Clinical role of fluorescence imaging in colorectal surgery - a review. Expert Rev Med Devices 2017; 14: 75-82. Go to original source... Go to PubMed...
    12. . Alander JT, Kaartinen I, Laakso A, et al. A review of indocyanine green fluorescent imaging in surgery. Int J Biomed Imaging 2012; 2012: 940-585. Go to original source... Go to PubMed...
    13. . Esposito C, Coppola V, Del Conte F, et al. Near-infrared fluorescence imaging using indocyanine green (ICG): emerging applications in pediatric urology. J Pediatr Urol 2020; 16: 700-707. Go to original source... Go to PubMed...
    14. . Hellan M, Spinoglio G, Pigazzi A, et al. The influence of fluorescence imaging on the location of bowel transection during robotic left-sided colorectal surgery. Surg Endosc 2014; 28: 1695-1702. Go to original source... Go to PubMed...
    15. . Boni L, David G, Mangano A, et al. Clinical applications of indocyanine green (ICG) enhanced fluorescence in laparoscopic surgery. Surg Endosc 2015; 29: 2046-2055. Go to original source... Go to PubMed...
    16. . Alander JT, Kaartinen I, Laakso A, et al. A review of indocyanine green fluorescent imaging in surgery. Int J Biomed Imaging 2012; 2012: 940-585. Go to original source... Go to PubMed...
    17. . Cahill RA, Mortensen NJ. Intraoperative augmented reality for laparoscopic colorectal surgery by intraoperative near infrared fluorescence imaging and optical coherence tomography. Minerva Chir 2010; 65: 451-462.
    18. . Gurtner GC, Jones GE, Neligan PC, et al. Intraoperative laser angiography using using the SPY system: review of the literature and recommendations for use. Ann Surg Innov Res 2013; 7: 1. Go to original source... Go to PubMed...
    19. . Ris F, Hompes R, Cunningham C, et al. Near-infrared (NIR) perfusion angiography in minimally invasive colorectal surgery. Surg Endosc 2014; 28: 2221-2226. Go to original source... Go to PubMed...
    20. . Sonntag O, Scholer A. Drug interference in clinical chemistry: recommendation of drugs and their concentrations to be used in drug interference studies. Ann Clin Biochem 2001; 38: 376-385. Go to original source... Go to PubMed...
    21. . Van Den Hoven P, Tange F, Van Der Valk J, et al. Normalization of time-intensity curves for quantification of foot perfusion using near-infrared fluorescence imaging with indocyanine green. J Endovasc Ther 2023; 30(3): 364-371. Go to original source... Go to PubMed...
    22. . Nijssen DJ, Joosten JJ, Osterkamp J, et al. Quantification of fluorescence angiography for visceral perfusion assessment: measuring agreement between two software algorithms. Surg Endosc 2024; 38(5): 2805-2816. Go to original source... Go to PubMed...
    23. . Delgado-Miguel C, Camps J, Hernandez Oliveros F. The role of indocyanine green in pediatric gastrointestinal surgery: systematic review. Eur J Pediatr Surg 2024; 34(1): 2-8. Go to original source... Go to PubMed...
    24. . Breuking EA, van Varsseveld OC, Harms M, et al. Safety and feasibility of indocyanine green fluorescence angiography in pediatric gastrointestinal surgery: a systematic review. J Pediatr Surg 2023; 58(8): 1534-1542. Go to original source... Go to PubMed...
    25. . Bokova E, Elhalaby I, Saylors S, et al. Utilization of indocyanine green (ICG) fluorescence in patients with pediatric colorectal diseases: the current applications and reported outcomes. Children (Basel) 2024; 11(6): 665. Go to original source... Go to PubMed...
    26. . Zibolen M, Zbojan J, Dluholucky S, et al. Praktická neonatologie. 1. vydání. Martin 2001.
    27. . Numanoglu A, Millar AJ. Necrotizing enterocolitis: early conventional and fluorescein laparoscopic assessment. J Pediatr Surg 2011; 46(2): 348-51. Go to original source... Go to PubMed...
    28. . Onishi S, Muto M, Yamada K, et al. Feasibility of delayed anastomosis for long gap esophageal atresia in the neonatal period using internal traction and indocyanine green-guided near-infrared fluorescence. Asian J Endosc Surg 2022; 15(4): 877-881. Go to original source... Go to PubMed...
    29. . Iinuma Y, Hirayama Y, Yokoyama N, et al. Intraoperative near-infrared indocyanine green fluorescence angiography (NIR-ICG AG) can predict delayed small bowel stricture after ischemic intestinal injury: Report of a case. J Pediatr Surg 2013; 48: 1123-1128. Go to original source... Go to PubMed...
    30. . Rentea RM, Halleran DR, Ahmad H, et al. Preliminary use of indocyanine green fluorescence angiography and value in predicting the vascular supply of tissues needed to perform cloacal, anorectal malformation, and Hirschsprung reconstructions. Eur J Pediatr Surg 2020; 30(6): 505-511. Go to original source... Go to PubMed...
    31. . Chandramouli B, Srinivasan K, Jagdish S, Ananthakrishnan N. Morbidity and mortality of colostomy and its closure in children. J Pediatr Surg 2004; 39(4): 596-9. Go to original source... Go to PubMed...
    32. . Yada K, Migita M, Nakamura R, et al. Indocyanine green fluorescence during pediatric stoma closure. J Pediatr Surg Case Rep 2020; 61: 101595. Go to original source...

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