[Thoracoscopic Stapler-based Segmentectomy Using Indocyanine Green(ICG)-infrared Thoracoscopy].

INTRODUCTIONS

Recently, reports of segmentectomy using indocyanine green (ICG) infrared thoracoscopy is gradually increasing. This method enables the clear identification of intersegmental line without the effect of collateral air drift, and seems useful especially for complex segmentectomy. On the other hand, the division of intersegmental plane using auto stapler recently seems to have some evidence of superiority of avoiding air-leakage over that using electrocautery. For these reasons, we have performed thoracoscopic stapler-based segmentectomy using ICG-infrared thoracoscopy.

METHODS

Consecutive 92 patients who underwent thoracoscopic segmentectomy using ICG-infrared thoracoscopy between July, 2016 and March, 2019 in our hospital were retrospectively evaluated.

RESULTS

Forty-seven patients were men, and the average age was 70 years (range, 30 to 90). The most target illness was primary lung cancer( 80.4%), but metastatic pulmonary tumor or inflammatory lung disease were also involved. Fifty-four patients (58.7%) underwent complex segmentectomy. Intersegmental borders were generally well recognized with ICG-infrared thoracoscopy. Only 2 cases needed small thoracotomy, but all the cases were completed segmentectomy. Neither 30-day nor 90-day mortality was observed. Postoperative complications [Common Terminology Criteria for Adverse Events( CTCAE)≥Grade 2] were seen in 11 patients( 12.0%). There was no complication related with the use of ICG. Postoperative air-leakage was seen in 2 patients( 2.2%). There was no case of delayed air-leakage who needed reinsertion of chest tube. Duration of chest tube insertion was 1 to 7 days after surgery( median 3 days). Length of stay after surgery was 3 to 18 ( median 5) days.

CONCLUSIONS

Thoracoscopic stapler-based segmentectomy using ICG-infrared thoracoscopy seems feasible and useful surgical procedure.