The role of indocyanine green fluorescence for intersegmental plane identification during video-assisted thoracoscopic surgery segmentectomies

• DOI: 10.21037/jtd.2018.04.84
• Publication Date: 2018-11-12T09:16:24Z
• Authors: Vadim G. Pischik; Aleksandr Kovalenko
• Keywords: Indocyanine Green; Bolus (digestion); Video-assisted thoracoscopic surgery

According to recent studies, thoracoscopic segmentectomy is an acceptable alternative lobectomy for treating different lung diseases. This approach appears have equivalent rates of postoperative morbidity with potentially similar long-term results even in selected cancer patients. At the same time, surgical success highly dependent on intraoperative interpretation segmental anatomy. We aimed analyze our experience and identify role indocyanine green (ICG)-fluorescence intersegmental plane detection.A total 86 consecutive patients who underwent 90 segmentectomies near-infrared-indocyanine (NIR-ICG) method between September 2015 December 2017 were investigated. preoperative 3D hilar model, vascular bronchial branches target segment divided. ICG was thereafter injected into central or peripheral vein. The boundary lines areas without fluorescence marked visceral pleura by electrocautery.The detected immediately after bolus injection vein all but had a time delay 10-25 seconds cases administration. median duration intensive staining seconds, regardless method. Well-defined borders observed (95.6%) due technical reasons three severe emphysema one. Chronic obstructive pulmonary disease (COPD) other did not impair line identification, reduced staining. No ICG-related complications observed.The ICG-fluorescence technology safe effective verification anatomic video-assisted surgery (VATS). perfusion-based technique has advantages surgeries compared methods. Doubling dose allows clear detection plane, certain suboptimal conditions.