Motono Nozomu, Iwai Shun, Funasaki Aika, Sekimura Atsushi, Usuda Katsuo, Uramoto Hidetaka
Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan.
J Med Case Rep. 2019 Jul 27;13(1):228. doi: 10.1186/s13256-019-2128-2.
The potential complications of pulmonary sequestration are serious and may include recurrent pulmonary infection, hemoptysis, and tumorigenesis. Therefore, the gold standard of treatment has been surgery. Although an adequate boundary between the nonfunctional lung and normal lung is required for the resection of pulmonary sequestration, the boundaries have been conventionally identified intraoperatively with inflation/deflation of the target segment by clamping and unclamping the relevant bronchus. The technique of visualizing the demarcation line based on near-infrared fluorescence imaging with indocyanine green was recently developed.
A 42-year-old Japanese woman with right Pryce III intralobar sequestration was admitted to our hospital. We planned video-assisted thoracoscopic wedge resection of the right sequestration using near-infrared fluorescence imaging with indocyanine green because of the small volume of the nonfunctional region. The aberrant artery was recognized in the pulmonary ligament; the artery was cut off after ligation. Indocyanine green at 5 mg/body was rapidly injected into the peripheral vein, and the boundary of the sequestration was clearly identified under near-infrared fluorescence imaging.
Near-infrared fluorescence imaging with indocyanine green is safe and useful for the identification of the boundary of a pulmonary sequestration.
肺隔离症的潜在并发症较为严重，可能包括反复肺部感染、咯血和肿瘤形成。因此，治疗的金标准一直是手术。尽管肺隔离症切除需要在无功能肺与正常肺之间有足够的界限，但传统上是在术中通过夹闭和松开相关支气管使目标节段充气/放气来确定界限。基于吲哚菁绿近红外荧光成像可视化分界线的技术最近得到了发展。
一名42岁的日本女性因右肺叶内普赖斯III型隔离症入住我院。由于无功能区域体积较小，我们计划使用吲哚菁绿近红外荧光成像进行电视辅助胸腔镜下右肺隔离症楔形切除术。在肺韧带中识别出异常动脉；结扎后切断该动脉。将5mg/体的吲哚菁绿快速注入外周静脉，在近红外荧光成像下可清晰识别隔离症的边界。
吲哚菁绿近红外荧光成像对于识别肺隔离症的边界安全且有用。
