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Comparative Study
. 2021 May;51(5):836-843.
doi: 10.1007/s00595-020-02137-w. Epub 2020 Sep 14.

A method to identify pulmonary intersegmental planes with intravenous vitamin B2 injection

Daisuke Saito  1 , Isao Matsumoto  2 , Ryuichi Waseda  3 , Keisuke Tatemichi  1 , Yusuke Tanaka  1 , Shuhei Yoshida  1 , Munehisa Takata  1 , Masaya Tamura  1 , Hirofumi Takemura  1
Affiliations
Comparative Study

A method to identify pulmonary intersegmental planes with intravenous vitamin B2 injection

Daisuke Saito et al. Surg Today. 2021 May.

Abstract

Purpose: The present study investigated whether the pulmonary intersegmental planes could be identified with the intravenous injection of vitamin B2 using a fluorescent camera and whether this method can be used instead of the inflation-deflation technique or the intravenous indocyanine green (ICG) method.

Methods: In experiment 1, the vitamin B2 was intravenously injected to visualize the pulmonary intersegmental plane and perform segmentectomy, and the visualized pulmonary intersegmental line was then compared to the inflation-deflation line in six pigs. In experiment 2, using six pigs, the fluorescent area and duration of fluorescence were compared after the intravenous injection of vitamin B2 and ICG in the same animals.

Results: In all animals in experiment 1, it was possible to clearly detect yellow-green fluorescence in the lung, in segments other than the one intended for resection, for at least 60 min. Moreover, the line visualized with vitamin B2 fluorescence matched the inflation-deflation line in all animals. In experiment 2, the area of vitamin B2 fluorescence corresponded to the area of ICG fluorescence in each animal.

Conclusions: The visualization of fluorescence after the intravenous injection of vitamin B2 using a fluorescent camera was a simple, safe, and accurate method for detecting intersegmental planes in a pig model. This method can be an alternative to the inflation-deflation technique and the intravenous ICG method.

Keywords: Fluorescence; Intersegmental plane; Lung segmentectomy; Non-small cell lung cancer; Vitamin B2.

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