Rudondy Quentin, Frey Sebastien, Bentellis Imad, Benkirane Tayeb, Cohen Charlotte, Benzaquen Jonathan, Ilie Marius, Gomez-Caro Abel, Berthet Jean-Phillippe
University of Cote d'Azur, Nice, France.
Department of Thoracic Surgery, Pasteur 1 Hospital, University Hospital of Nice, Nice, France.
Thorac Cancer. 2024 Apr;15(12):994-1006. doi: 10.1111/1759-7714.15274. Epub 2024 Mar 18.
Video-assisted thoracoscopic segmentectomies have become the gold standard for the treatment of early-stage non-small cell lung cancer less than two centimeters. The main difficulty is the identification of intersegmental boundary lines which dictate postoperative morbidities.
We conducted a retrospective study to compare the perioperative outcomes of patients who underwent minimally invasive segmentectomy using the traditional deflation-inflation method or the novel indocyanine green (ICG) technique. Using a prospectively maintained database, we performed a retrospective analysis of 197 consecutive anatomical segmentectomies, from 2020 to 2023. Clinical effectiveness, postoperative complications, and histological data were compared.
A total of 73 (37%) patients had the inflation-deflation method and 124 (63%) had the intravenous ICG method. There were no significant differences in chest tube duration, prolonged air leak, postoperative complications, and postoperative hospital stays. Surgical margin width was also similar between the two groups. The multivariable analysis confirmed these results. Lastly, intravenous ICG brought no additional value in complex segmentectomies.
This monocentric and retrospective analysis found no added value of the intravenous ICG on the perioperative results of minimally invasive segmentectomies. The place of this novel technique in the surgical armamentarium remains to be defined. Specific indications such as complex segmentectomy or patients with chronic pulmonary disease require further study.
电视辅助胸腔镜肺段切除术已成为治疗直径小于2厘米的早期非小细胞肺癌的金标准。主要困难在于识别决定术后发病率的肺段间边界线。
我们进行了一项回顾性研究，比较采用传统的萎陷-膨胀法或新型吲哚菁绿（ICG）技术进行微创肺段切除术患者的围手术期结果。利用一个前瞻性维护的数据库，我们对2020年至2023年连续197例解剖性肺段切除术进行了回顾性分析。比较了临床疗效、术后并发症和组织学数据。
共有73例（37%）患者采用萎陷-膨胀法，124例（63%）患者采用静脉注射ICG法。两组在胸管留置时间、持续性漏气、术后并发症和术后住院时间方面无显著差异。两组的手术切缘宽度也相似。多变量分析证实了这些结果。最后，静脉注射ICG在复杂肺段切除术中没有带来额外价值。
这项单中心回顾性分析发现，静脉注射ICG对微创肺段切除术的围手术期结果没有附加价值。这项新技术在手术器械库中的地位仍有待确定。复杂肺段切除术或慢性肺病患者等特定适应症需要进一步研究。
