Li Chengqiang, Zhang Xianfei, Feng Xijia, Han Dingpei, Xiang Jie, Li Hecheng
Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
JTCVS Tech. 2023 Jan 16;18:137-142. doi: 10.1016/j.xjtc.2022.12.007. eCollection 2023 Apr.
Pulmonary segmentectomy should be the standard surgical procedure for patients in certain clinical scenarios. However, detecting the intersegmental planes both on the pleural surface and within the lung parenchyma remains a challenge. We developed an intraoperative novel method for distinguishing intersegmental planes of the lung via transbronchial injection of iron sucrose (ClinicalTrials.gov number, NCT03516500).
We first performed a bronchial injection of iron sucrose to identify the intersegmental plane of the porcine lung. Then, we conducted a prospective study to evaluate the safety and feasibility of the technique in 20 patients who underwent anatomic segmentectomy. Iron sucrose was injected into the bronchus of target pulmonary segments, and the intersegmental planes were divided with electrocautery or stapler.
The median injection of iron sucrose was 90 mL (range, 70-120 mL), and the median time from injection of iron sucrose to demarcation of intersegmental plane was 8 minutes (range, 3-25 minutes). Qualified identification of the intersegmental plane was observed in 17 cases (85%). The intersegmental plane could not be recognized in 3 cases. All patients experienced no complications related to iron sucrose injection or complications of Clavien-Dindo grade 3 or more.
Transbronchial injection of iron sucrose is a simple, safe, and feasible approach to identify the intersegmental plane (NCT03516500).
在某些临床情况下，肺段切除术应是患者的标准手术方式。然而，在胸膜表面和肺实质内检测肺段间平面仍然是一项挑战。我们开发了一种术中通过经支气管注射蔗糖铁来区分肺段间平面的新方法（ClinicalTrials.gov编号，NCT03516500）。
我们首先对猪肺进行支气管注射蔗糖铁以识别肺段间平面。然后，我们进行了一项前瞻性研究，以评估该技术在20例行解剖性肺段切除术患者中的安全性和可行性。将蔗糖铁注入目标肺段的支气管，并用电灼或吻合器划分肺段间平面。
蔗糖铁的中位注射量为90毫升（范围70 - 120毫升），从注射蔗糖铁到划分肺段间平面的中位时间为8分钟（范围3 - 25分钟）。17例（85%）观察到肺段间平面的合格识别。3例未识别出肺段间平面。所有患者均未出现与蔗糖铁注射相关的并发症或Clavien - Dindo 3级及以上并发症。
经支气管注射蔗糖铁是一种识别肺段间平面的简单、安全且可行的方法（NCT03516500）。
