Near-infrared intraoperative imaging with indocyanine green is beneficial in video-assisted thoracoscopic segmentectomy
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(2020) 15:303
RESEARCH ARTICLE
Open Access
Near-infrared intraoperative imaging with indocyanine green is beneficial in videoassisted thoracoscopic segmentectomy for patients with chronic lung diseases: a retrospective single-center propensity-score matched analysis Zhengcheng Liu1,2, Rusong Yang1,2*
and Hui Cao1,2
Abstract Objective: To investigate whether video-assisted thoracoscopic segmentectomy using near-infrared fluorescence imaging had better intersegmental plane visualization and peri-operative outcome in patients with chronic lung diseases. Methods: Data were collected retrospectively from March 2014 and August 2019. A total of 92 patients with pulmonary nodules underwent near-infrared fluorescence guided uni-port thoracoscopic segmentectomy(NIF-VATS), 149 patients underwent thoracoscopic segmentectomy with inflation-deflation method(ID-VATS). After 1:1 propensity matching, perioperative outcomes between NIF-VATS and ID-VATS was compared. Results: Incision size was 3 cm in both group.Mean operative time was 79 min in NIF-VATS group and 96 min in ID-VATS group. The intersegmental plane was not clear in 33 cases of ID-VATS group, and no clear boundary was found after prolonged waiting time. Emphysema or pulmonary bullae could be found in chest CT scan in these patients, they all were diagnosed as chronic obstructive pulmonary disease. In NIF-VATS group, the intersegmental plane was not clear in 8 cases. Under the guidance of three-dimensional reconstruction and preoperative positioning, the oncological margin length of both groups met the requirements of surgical quality control. The intraoperative blood loss, number of lymph node resection, showed no statistical difference between the two groups. Postoperative air leakage was more often observed in ID-VATS group. The postoperative drainage duration, postoperative hospitalization time was shorter in ID-VATS group. Conclusions: Compared with inflation-deflation method, segmentectomy using NIF imaging is feasible for patients with chronic lung diseases with better intersegmental plane, shorter operation time, less complications, it might lead to faster recovery. Keywords: Near-infrared intraoperative imaging, Intersegmental border, Segmentectomy, Chronic lung diseases
* Correspondence: [email protected] 1 Department of Thoracic Surgery, Nanjing Chest Hospital, Treatment and Research Center for Pulmonary Nodule in Nanjing Medical University, Nanjing 210029, China 2 Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing 210029, China © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated othe
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