Indocyanine green fluorescence significantly lowers anastomotic leak rates in colorectal surgery, crucial for surgical decision-making.

• Patients who received ICG had a 36% lower rate of anastomotic leaks compared to those with standard white light (OR=0.64; p<0.0001).
• Surgical strategy changes were more frequent in the ICG group (OR=7.50; p=0.02), indicating adaptability in approach.

Consider implementing ICG, especially for left-sided and rectal resections, to enhance patient outcomes.

• No differences observed in reoperation rates (OR=0.94; p=0.64).