Indocyanine green fluorescence during pediatric stoma closure

Abstract

Abstract In this paper, we discuss the first two cases who underwent colostomy closure using ICG fluorescence system (Stryker, PINPOINT System®). Case 1 11-months-old female with 21 trisomy and anorectal malformation (rectal atresia without fistula). She had sigmoid loop colostomy in neonatal period and Posterior Sagittal Anorectoplasty (PSARP) in 9 months of life. During the colostomy closure, ICG was intravenously administered to evaluate blood flow of anastomotic site. Twenty-two hours after operation, she had the first defecation which was positive for ICG fluorescence. Case 2 16-months old male with postoperative state of tracheoesophageal fistula and rectovestivular fistula. He had transverse loop colostomy in neonatal period and PSARP in 12 months of life. During the colostomy closure, ICG was intravenously administered to evaluate blood flow of anastomotic site. Twenty-five hours after operation, he had the first defecation which was negative for ICG fluorescence. Forty hours after operation, he had ICG-positive defecation. There were no postoperative complications for both of patients. ICG fluorescence system has two merits for pediatric colostomy closure evaluation of anastomotic blood flow and postoperative bowel function.