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. 2024 Oct 9;24(1):299.
doi: 10.1186/s12893-024-02582-1.

Indocyanine green fluorescence identification of the intersegmental plane by the target segmental vein-first single-blocking during thoracoscopic segmentectomy

Yungang Sun #  1   2   3 , Yu Zhuang #  1   2   3 , Zhao Wang #  1   2   3 , Siyang Jiao  1   2   3 , Mengxu Yao  1   2   3 , Qiang Zhang  4   5   6 , Feng Shao  7   8   9
Affiliations

Indocyanine green fluorescence identification of the intersegmental plane by the target segmental vein-first single-blocking during thoracoscopic segmentectomy

Yungang Sun et al. BMC Surg. .

Abstract

Background: Innovative attempt to explore the feasibility and accuracy of using indocyanine green fluorescence (ICGF) to identify the intersegmental plane by the target segmental veins preferential ligation during thoracoscopic segmentectomy.

Methods: A retrospective analysis was conducted on clinical data of 32 consecutive patients who underwent thoracoscopic segmentectomy with intersegmental plane identification using both ICGF and inflation-deflation method after target segmental veins prioritized blocking at Nanjing Chest Hospital from December 2022 to June 2023. Preoperative three-dimensional reconstruction was used to identify the target segment and the anatomical structure of the arteries, veins, and bronchi. After ligating the target segmental veins during surgery, the first intersegmental plane was immediately identified and marked with an electrocoagulation device using an inflation-deflation method. Subsequently, the second intersegmental plane was determined using the ICGF method. Finally, the consistency of the two intersegmental planes was evaluated.

Results: All the 32 patients successfully completed thoracoscopic segmentectomy without ICG-related complications and perioperative death. The average operation time was (98.59 ± 20.72) min, the average intraoperative blood loss was (45.31 ± 35.65) ml, and the average postoperative chest tube removal time was (3.5 ± 1.16) days. The average postoperative hospital stay was (4.66 ± 1.29) days, and the average tumor margin width was (26.96 ± 5.86) mm. The intersegmental plane determined by ICGF method was basically consistent with inflation-deflation method in all patients.

Conclusion: The ICGF can safely and accurately identify the intersegmental plane by target segmental veins preferential ligation during thoracoscopic segmentectomy, which is a beneficial exploration and important supplement to the simplified thoracoscopic anatomical segmentectomy.

Keywords: Fluorescence; Indocyanine green; Pulmonary circulation; Pulmonary vein; Segmentectomy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
a A 40-year-old female patient with thin-section CT showing a 14 mm ground glass opacity (GGO) in the lingual segment (S4+5) of the left upper lung. b Preoperative three-dimensional reconstruction image indicating that the lingual segment vein consists of two branches (V4 and V5), V4 and V5 were severed respectively. c The inflation-deflation plane formed after anatomically disconnecting the lingual veins, marked using an electrocoagulation device. d The visualization of intersegmental plane by indocyanine green fluorescence method
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References

    1. Zhang M, Mao N, Wu QC, Ge MJ. A novel method for distinguishing the intersegmental plane: pulmonary circulation single-blocking. J Thorac Dis. 2021;13(1):362–5. - PMC - PubMed
    1. Zhang M, Wu QC, Ge MJ. The VVBA method for thoracoscopic right middle lobe segmentectomy. Gen Thorac Cardiovasc Surg. 2021;69(1):175–7. - PubMed
    1. Zhang M, Mao N, Wu QC, Ge MJ. Vein or artery-first resection in right middle lobe segmentectomy: which preserves more lung? Interact Cardiovasc Thorac Surg. 2021;32(6):993–5. - PMC - PubMed
    1. Fu HH, Feng Z, Li M, Wang H, Ren WG, Peng ZM. The arterial-ligation-alone method for identifying the intersegmental plane during thoracoscopic anatomic segmentectomy. J Thorac Dis. 2020;12(5):2343–51. - PMC - PubMed
    1. He H, Zhao H, Ma L, Fan K, Feng J, Zhao R, Wen X, Zhang J, Wu Q, Fu J, et al. Identification of the intersegmental plane by arterial ligation method during thoracoscopic segmentectomy. J Cardiothorac Surg. 2022;17(1):281. - PMC - PubMed

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