Frontiers in Oncology

**117**

**Chapter 6**

**Abstract**

cancer resections.

**1. Introduction**

captured by an image system.

Indocyanine Green Fluorescence

Fluorescence vision using indocyanine green is a surgical tool with increasing applications in colorectal cancer surgery. This tool has received acceptance in several disciplines as a potential method to improve visualization of the surgical field, improve lymph node resection and decrease the incidence of anastomotic leaks (ALs). In colorectal surgery specifically, some studies have shown that intraoperative fluorescence imaging is a safe and feasible method to evaluate anastomotic perfusion, and its use could affect the incidence of anastomotic leaks. Currently, controlled trials are carried out to validate these conclusions, as well as new indications for indocyanine green such as detection and guidance in the management of hepatic colorectal metastases, visualization of ureters and even as tumor marking and improvement the lymph node harvest of early tumors. These advances could offer great value to surgeons and patients, by improving the accuracy and results of

**Keywords:** indocyanine green fluorescence, colorectal cancer surgery, anastomotic

Some basic concepts are necessary to define as Fluorescence, which is a form of luminescence, that is, it is a process of light emission, caused by an energy, in this case it is by ultraviolet rays and that said energy is absorbed in form of electromagnetic radiation to later be emitted in the form of wavelengths and thus can be

And what is the Indocyanine green? (ICG). As it is a colorant that is soluble in water and has a spectral absorption of light of approximately 800 nanometers, this spectrum is capable of binding both oxygenated and reduced hemoglobin and has 5 pharmacological characteristics: one that is not metabolized by therefore it is considered almost inert by binding to plasma proteins. Two, which is eliminated by a concentration gradient, that is, passively. Three, it is eliminated by the hepatocyte into the bile canaliculi. Four, it does not suffer from enterohepatic circulation and fifth, that its use is clearly diagnostic and not curative since its approval by the FDA in 1960 when Fox IJ of Mayo Clinic [1], showed in a work the physical and metabolic properties of this substance and its use diagnosis in liver diseases,

Colorectal Cancer is the 4th most frequent in the USA, more than 135,000 new cases are diagnosed per year, of which 95,500 are colon and almost 40,000 rectal, with an estimated and unfortunate mortality of more than 50,000 cases, that is,

in Colorectal Cancer

*Elvis Vargas and Cesar Ginesta*

leaks, tumor marking, lymph node harvest

ophthalmological, cardiac, neurological, etc.
