Incidence of colorectal cancer is steadily rising

• Colorectal cancer is the third most commonly diagnosed cancer type in the world and the second most deadly
• In Denmark the risk of getting colorectal cancer is 3,4% for men and 2.8% for women before age 75 years

[1] International Agency for Research on Cancer (IARC), WHO
[2] The Danish Cancer Society

Surgical treatment is often applied

• Surgical treatment aims to remove the tumor and rejoin the intestines, creating an anastomosis
• Securing sufficient blood supply to the anastomosis is crucial to ensure healing and avoid anastomotic leak

Anastomotic leak is a frequent and serious complication

• Anastomotic leak occurs in 5-20% of colorectal cancer surgery
• Anastomotic leak significantly increases the morbidity of colorectal surgey from 20% to 60% and mortality from <5% to 20%
• Patients surviving anastomotic leak suffer long-term consequences with reduced quality of life often with a permanent stoma

[5] Thornton M, Joshi H, Vimalachandran C, et al. Int J Colorectal Dis. 2011
[6] Vonlanthen R, Slankamenac K, Breitenstein S, et al. Ann Surg. 2011  

Today tissue perfusion is evaluated subjectively

• Surgeons do their utmost to evaluate tissue perfusion but no standardized method exist
• Current techiques include visual judgment of tissue color, bleeding edges of resected margins and pulsation
• Injection of the fluorescent dye Indocyanine Green (ICG) provides important information on tissue perfusion but visual evaluation of colour intensity remains subjective

[7] Boni L, David G, Dionigi G, et al. Surg Endosc. 2016