Motono Nozomu, Iwai Shun, Funasaki Aika, Sekimura Atsushi, Usuda Katsuo, Uramoto Hidetaka
Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Ishikawa, Japan.
J Thorac Dis. 2019 Mar;11(3):702-707. doi: 10.21037/jtd.2019.02.70.
A technique of visualizing the demarcation line based with indocyanine green (ICG) was recently developed, and its utility was reported. We demonstrated the safety and utility of low-dose (5 mg/body) ICG fluorescence-navigated video-assisted thoracic surgery (VATS) segmentectomy.
Patients who had undergone lung segmentectomy for early-stage non-small cell lung cancer (NSCLC) or small pulmonary metastasis were included in this study. ICG at 5 mg/body was rapidly injected into the peripheral vein, and the lung was observed using near-infrared (NIR) fluorescence thoracoscopy. We evaluated the identification rate of the demarcation line based on NIR fluorescence imaging with ICG and the perioperative outcomes.
Lung segmentectomy NIR fluorescence imaging with ICG was performed in 20 patients. The identification of the target segmental line was possible in 18 (90%) of the 20 patients. The median duration of chest tube placement was one day, and the median length of postoperative stay was 8 days. Complications occurred in 5 (25%) of the 20 patients. All cases were prolonged air leak that required pleurodesis. There were no complications resulting from NIR fluorescence imaging with ICG.
NIR fluorescence imaging with ICG is safe and useful for the identification of the demarcation line for lung segmentectomy. Low-dose ICG might achieve a sufficient rate of identification of the segmental line.
一种基于吲哚菁绿（ICG）可视化分界线的技术最近被开发出来，并报道了其效用。我们证明了低剂量（5毫克/体）ICG荧光导航电视辅助胸腔镜手术（VATS）肺段切除术的安全性和效用。
本研究纳入了因早期非小细胞肺癌（NSCLC）或小的肺转移而接受肺段切除术的患者。将5毫克/体的ICG快速注入外周静脉，使用近红外（NIR）荧光胸腔镜观察肺。我们基于ICG的NIR荧光成像评估了分界线的识别率和围手术期结果。
对20例患者进行了ICG的肺段切除术NIR荧光成像。20例患者中有18例（90%）能够识别目标节段线。胸管放置的中位持续时间为1天，术后住院的中位时长为8天。20例患者中有5例（25%）发生了并发症。所有病例均为需要胸膜固定术的持续性漏气。ICG的NIR荧光成像未导致并发症。
ICG的NIR荧光成像对于识别肺段切除术的分界线是安全且有用的。低剂量ICG可能实现足够的节段线识别率。
