Wang C, Liu Y, Yang L, Liu S K
Minimally Invasive Treatment Center, Beijing Chest Hospital, Beijing 101149, China.
Zhonghua Yi Xue Za Zhi. 2020 Feb 25;100(7):538-540. doi: 10.3760/cma.j.issn.0376-2491.2020.07.012.
To investigate the effectiveness and safety of CT-guided intrapulmonary injection of indocyanine green (ICG) for preoperative localization of small pulmonary nodules and ground glass opacities. From October 2018 to July 2019, a total of 34 consecutive patients (39 nodules) who were suspected to be lung cancer and underwent thoracoscopic surgery were enrolled. The size of the nodules was 0.3-2.0 (0.9±0.3) cm, including 6 solid nodules, 9 impure ground glass nodules and 24 pure ground glass nodules. Before operation, ICG was injected into the lung under the guidance of CT for localization. The patient's nodules location, operation and pathology were recorded. The main outcome measures were localization success rate and complication rate. Seven patients (20.6%) had mild complications including six pneumothorax and one intrapulmonary hemorrhage,but all these patients need no special treatment. There was no ICG related side effection all patients. ICG fluorescence can be observed in all localized nodules during surgery. In two patients, the fluorescence was diffused in the thoracic cavity, but the lesion can still be found at the brightest spot of fluorescence. Thirty-eight (97.4%) lesions were successfully found under fluorescence guidance, only one nodule was not found because of its small size (0.3 cm). The shortest fluorescence retention time was more than 5 hours. CT-guided intrapulmonary injection of ICG for localization of pulmonary nodules and ground glass opacities is safe and effective.
探讨CT引导下肺内注射吲哚菁绿(ICG)用于术前定位小肺结节及磨玻璃影的有效性和安全性。2018年10月至2019年7月,连续纳入34例疑似肺癌并接受胸腔镜手术的患者(共39个结节)。结节大小为0.3 - 2.0(0.9±0.3)cm,其中实性结节6个,不纯磨玻璃结节9个,纯磨玻璃结节24个。术前在CT引导下将ICG注入肺内进行定位。记录患者结节位置、手术及病理情况。主要观察指标为定位成功率和并发症发生率。7例患者(20.6%)出现轻度并发症,其中气胸6例,肺内出血1例,但所有这些患者均无需特殊治疗。所有患者均未出现与ICG相关的不良反应。术中在所有定位的结节中均能观察到ICG荧光。2例患者荧光在胸腔内弥漫,但仍可在荧光最亮处发现病变。38个(97.4%)病变在荧光引导下成功找到,仅1个0.3 cm的小结节因太小未被发现。最短荧光保留时间超过5小时。CT引导下肺内注射ICG用于肺结节及磨玻璃影定位安全有效。