Anayama Takashi, Hirohashi Kentaro, Okada Hironobu, Miyazaki Ryohei, Yamamoto Marino, Kawamoto Nobutaka, Orihashi Kazumasa
Department of Thoracic Surgery, Kochi University, Nankoku, Japan.
Kyobu Geka. 2019 Jul;72(7):523-527.
Early stage lung cancers which localized in the middle layer or the center of the lung become indications for anatomical segmentectomy. As a method of intraoperative identifying the intra-segmental plane, 2 different techniques utilizing indocyanine green (ICG) fluorescence has been clinically applied. The one is a method of systemically intravenous administration of ICG after ligating the objective segmental pulmonary artery. The other is a method of insufflate the diluted ICG into the objective segmental bronchus under the bronchoscope. The segmental alveoli were visualized with a ICG fluorescence thoracoscope. Both methods visualize inter-segmental plane. Both advantages and disadvantages were discussed. These methods may help the repertoire of atypical segmentectomy getting wider. Also, ICG fluorescence imaging is incorporated into a robotic surgery. ICG fluorescence imaging is expected to be applied to various applications of thoracic surgery.
局限于肺中层或中央的早期肺癌成为解剖性肺段切除术的适应证。作为术中识别段间平面的一种方法,两种利用吲哚菁绿(ICG)荧光的不同技术已在临床上应用。一种是在结扎目标段肺动脉后全身静脉注射ICG的方法。另一种是在支气管镜下将稀释的ICG注入目标段支气管的方法。用ICG荧光胸腔镜观察段内肺泡。两种方法均可显示段间平面。讨论了两者的优缺点。这些方法可能有助于扩大非典型肺段切除术的范围。此外,ICG荧光成像已被纳入机器人手术。ICG荧光成像有望应用于胸外科的各种手术。