Usefulness of colonic tattooing using indocyanine green in patients with colorectal tumors

AIM To prove that tattooing using indocyanine green (ICG) is feasible in laparoscopic surgery for a colon tumor. METHODS From January 2012 to December 2016, all patients who underwent laparoscopic colonic surgery were retrospectively screened, and 1010 patients with colorectal neoplasms were included. Their lesions were tattooed with ICG the day before the operation. The tattooed group (TG) included 114 patients, and the non-tattooed group (NTG) was selected by propensity score matching of subjects based on age, sex, tumor staging, and operation method (n = 228). In total, 342 patients were enrolled. Between the groups, the changes in [Delta (Delta), preoperative-postoperative] the hemoglobin and albumin levels, operation time, hospital stay, oral ingestion period, transfusion, and perioperative complications were compared. RESULTS Preoperative TG had a shorter operation time (174.76 +/- 51.6 min vs 192.63 +/- 59.9 min, P < 0.01), hospital stay (9.55 +/- 3.36 d vs 11.42 +/- 8.23 d, P < 0.01), and postoperative oral ingestion period (1.58 +/- 0.96 d vs 2.81 +/- 1.90 d, P < 0.01). The Delta hemoglobin (0.78 +/- 0.76 g/dL vs 2.2 +/- 1.18 g/dL, P < 0.01) and Delta albumin (0.41 +/- 0.44 g/dL vs 1.08 +/- 0.39 g/dL, P < 0.01) levels were lower in the TG. On comparison of patients in the N0 and N1 or N2 groups, the N0 colon cancer group had a better operation time, length of hospital stay, oral ingestion period, Delta hemoglobin, and Delta albumin results than those of the N1 or N2 group. The operation methods affected the results, and laparoscopic anterior resection (LAR) showed similar results. However, for left and right hemicolectomy, both groups showed no difference in operation time or hospital stay. CONCLUSION Preoperative tattooing with ICG is useful for laparoscopic colectomy, especially in the N0 colon cancer group and LAR.