Indocyanine green fluorescence angiography significantly lowers anastomotic leakage rates in colorectal surgery, improving patient outcomes.

• Anastomotic leakage was 7.9% in the indocyanine green group compared to 11.6% in controls (risk ratio 0.69, p < .001).
• The finding is robust, supported by a review of 4,636 patients across seven trials.

Surgeons should consider using fluorescence angiography to enhance surgical safety, especially for high-risk patients.

• More research is needed for specific cases like low anastomoses.