Interesting new Finnish RCT in @JAMASurgery evaluating ICG's impact on anastomotic leak in colon surgery. The results won't make you switch camps, regardless of which one you're in, but they're important: -No difference in AL rates, reoperations, or overall complications between the ICG and control groups. -Trend toward decreased AL in left-sided anastomoses for ICG (interpret with caution) -No patients received oral abx, and the group was mixed on no prep vs mechanical vs enemas. -LARs excluded, which would have presumably been at a higher risk of compromised perfusion and leak, and were the focus of previous studies. -Anastomotic configurations varied, with a lot of isoperistaltic linear right-sided anastomoses, and 20% of left-sided anastomoses either linear or handsewn (vs circular stapled). -More than 50% of surgeons in their first 10 years of practice, and about 30% with less than 50 previous lap colon cases. -Overall leak rates of 6-10%, which is probably higher than what a lot of us quote patients. Take home point (IMHO): perfusion is but one of many contributors to anastomotic leak, and ICG may make you feel better, but it won't bring your leak rate below 5%. jamanetwork.com/journals/jam…