Feasibility Investigation of Fluorescence Method in Uniport Thoracoscopic Anatomical Segmentectomy for Identifying the Intersegmental Boundary Line

Background and objective Segmentectomy has gradually become one of the standard surgical methods for small pulmonary nodules with early lung cancer on imaging. This study aimed to investigate the perioperative outcomes of patients who underwent uniport video-assisted thoracoscopic surgery (VATS) seg...

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Autores principales:	Yungang SUN, Qiang ZHANG, Zhao WANG, Feng SHAO
Formato:	article
Lenguaje:	ZH
Publicado:	Chinese Anti-Cancer Association; Chinese Antituberculosis Association 2021
Materias:	uniportal thoracoscopy segmentectomy intersegmental boundary line fluorescence method modified inflation-deflation Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/0ceaec3b619749ef9108023f16213300
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spelling	oai:doaj.org-article:0ceaec3b619749ef9108023f162133002021-11-19T06:49:15ZFeasibility Investigation of Fluorescence Method in Uniport Thoracoscopic Anatomical Segmentectomy for Identifying the Intersegmental Boundary Line1009-34191999-618710.3779/j.issn.1009-3419.2021.102.38https://doaj.org/article/0ceaec3b619749ef9108023f162133002021-11-01T00:00:00Zhttp://dx.doi.org/10.3779/j.issn.1009-3419.2021.102.38https://doaj.org/toc/1009-3419https://doaj.org/toc/1999-6187Background and objective Segmentectomy has gradually become one of the standard surgical methods for small pulmonary nodules with early lung cancer on imaging. This study aimed to investigate the perioperative outcomes of patients who underwent uniport video-assisted thoracoscopic surgery (VATS) segmentectomy for identifying the intersegmental boundary line (IBL) by the near-infrared fluorescence imaging with intravenous indocyanine green (ICG) method or the modified inflation-deflation (MID) method and assess the feasibility and effectiveness of the ICG fluorescence (ICGF)-based method. Methods We retrospectively analyzed the perioperative data in total 198 consecutive patients who underwent uniport VATS segmentectomy between February 2018 and August 2020. With the guidance of preoperative intelligent/interactive qualitative and quantitative analysis-three dimensional (IQQA-3D), the targeted segment structures could be precisely identified and dissected, and then the IBL was confirmed by ICGF-based method or MID method. Clinical effectiveness and postoperative complications of the two methods were evaluated. Results An IBL was visible in 98% of patients by the ICGF-based group, even with the low-doses of ICG. The ICGF-based group was significantly associated with the shorter IBL clear presentation time [(23.59±4.47) s vs (1,026.80±318.34) s] (P<0.01) and operative time [(89.3±31.6) min vs (112.9±33.3) min] (P<0.01), compared to the MID group. The incidence of postoperative prolonged air leaks was higher in the MID group than in the ICGF-based group (8.0% vs 26.5%, P=0.025). There were no significant differences in bleeding volume, chest tube duration, postoperative hospital stays, surgical margin width and other postoperative complications (P>0.05). Conclusion The ICGF-based method could highly accurately identify the IBL and make anatomical segmentectomy easier and faster, and therefore has the potential to be a feasible and effective technique to facilitate the quality of uniport VATS segmentectomy.Yungang SUNQiang ZHANGZhao WANGFeng SHAOChinese Anti-Cancer Association; Chinese Antituberculosis Associationarticleuniportal thoracoscopysegmentectomyintersegmental boundary linefluorescence methodmodified inflation-deflationNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ZHChinese Journal of Lung Cancer, Vol 24, Iss 11, Pp 756-763 (2021)
institution	DOAJ
collection	DOAJ
language	ZH
topic	uniportal thoracoscopy segmentectomy intersegmental boundary line fluorescence method modified inflation-deflation Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	uniportal thoracoscopy segmentectomy intersegmental boundary line fluorescence method modified inflation-deflation Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Yungang SUN Qiang ZHANG Zhao WANG Feng SHAO Feasibility Investigation of Fluorescence Method in Uniport Thoracoscopic Anatomical Segmentectomy for Identifying the Intersegmental Boundary Line
description	Background and objective Segmentectomy has gradually become one of the standard surgical methods for small pulmonary nodules with early lung cancer on imaging. This study aimed to investigate the perioperative outcomes of patients who underwent uniport video-assisted thoracoscopic surgery (VATS) segmentectomy for identifying the intersegmental boundary line (IBL) by the near-infrared fluorescence imaging with intravenous indocyanine green (ICG) method or the modified inflation-deflation (MID) method and assess the feasibility and effectiveness of the ICG fluorescence (ICGF)-based method. Methods We retrospectively analyzed the perioperative data in total 198 consecutive patients who underwent uniport VATS segmentectomy between February 2018 and August 2020. With the guidance of preoperative intelligent/interactive qualitative and quantitative analysis-three dimensional (IQQA-3D), the targeted segment structures could be precisely identified and dissected, and then the IBL was confirmed by ICGF-based method or MID method. Clinical effectiveness and postoperative complications of the two methods were evaluated. Results An IBL was visible in 98% of patients by the ICGF-based group, even with the low-doses of ICG. The ICGF-based group was significantly associated with the shorter IBL clear presentation time [(23.59±4.47) s vs (1,026.80±318.34) s] (P<0.01) and operative time [(89.3±31.6) min vs (112.9±33.3) min] (P<0.01), compared to the MID group. The incidence of postoperative prolonged air leaks was higher in the MID group than in the ICGF-based group (8.0% vs 26.5%, P=0.025). There were no significant differences in bleeding volume, chest tube duration, postoperative hospital stays, surgical margin width and other postoperative complications (P>0.05). Conclusion The ICGF-based method could highly accurately identify the IBL and make anatomical segmentectomy easier and faster, and therefore has the potential to be a feasible and effective technique to facilitate the quality of uniport VATS segmentectomy.
format	article
author	Yungang SUN Qiang ZHANG Zhao WANG Feng SHAO
author_facet	Yungang SUN Qiang ZHANG Zhao WANG Feng SHAO
author_sort	Yungang SUN
title	Feasibility Investigation of Fluorescence Method in Uniport Thoracoscopic Anatomical Segmentectomy for Identifying the Intersegmental Boundary Line
title_short	Feasibility Investigation of Fluorescence Method in Uniport Thoracoscopic Anatomical Segmentectomy for Identifying the Intersegmental Boundary Line
title_full	Feasibility Investigation of Fluorescence Method in Uniport Thoracoscopic Anatomical Segmentectomy for Identifying the Intersegmental Boundary Line
title_fullStr	Feasibility Investigation of Fluorescence Method in Uniport Thoracoscopic Anatomical Segmentectomy for Identifying the Intersegmental Boundary Line
title_full_unstemmed	Feasibility Investigation of Fluorescence Method in Uniport Thoracoscopic Anatomical Segmentectomy for Identifying the Intersegmental Boundary Line
title_sort	feasibility investigation of fluorescence method in uniport thoracoscopic anatomical segmentectomy for identifying the intersegmental boundary line
publisher	Chinese Anti-Cancer Association; Chinese Antituberculosis Association
publishDate	2021
url	https://doaj.org/article/0ceaec3b619749ef9108023f16213300
work_keys_str_mv	AT yungangsun feasibilityinvestigationoffluorescencemethodinuniportthoracoscopicanatomicalsegmentectomyforidentifyingtheintersegmentalboundaryline AT qiangzhang feasibilityinvestigationoffluorescencemethodinuniportthoracoscopicanatomicalsegmentectomyforidentifyingtheintersegmentalboundaryline AT zhaowang feasibilityinvestigationoffluorescencemethodinuniportthoracoscopicanatomicalsegmentectomyforidentifyingtheintersegmentalboundaryline AT fengshao feasibilityinvestigationoffluorescencemethodinuniportthoracoscopicanatomicalsegmentectomyforidentifyingtheintersegmentalboundaryline
_version_	1718420295698612224

Feasibility Investigation of Fluorescence Method in Uniport Thoracoscopic Anatomical Segmentectomy for Identifying the Intersegmental Boundary Line

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