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Novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green

OBJECTIVES: The aim of this study is to assess prospectively the validity and feasibility of segmentectomy using preoperative simulation and intravenous indocyanine green (ICG) with near-infrared (NIR) light thoracoscope to ensure a sufficient surgical margin. METHODS: This study was a prospective,...

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Autores principales: Matsuura, Natsumi, Igai, Hitoshi, Ohsawa, Fumi, Numajiri, Kazuki, Kamiyoshihara, Mitsuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297503/
https://www.ncbi.nlm.nih.gov/pubmed/35237828
http://dx.doi.org/10.1093/icvts/ivac064
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author Matsuura, Natsumi
Igai, Hitoshi
Ohsawa, Fumi
Numajiri, Kazuki
Kamiyoshihara, Mitsuhiro
author_facet Matsuura, Natsumi
Igai, Hitoshi
Ohsawa, Fumi
Numajiri, Kazuki
Kamiyoshihara, Mitsuhiro
author_sort Matsuura, Natsumi
collection PubMed
description OBJECTIVES: The aim of this study is to assess prospectively the validity and feasibility of segmentectomy using preoperative simulation and intravenous indocyanine green (ICG) with near-infrared (NIR) light thoracoscope to ensure a sufficient surgical margin. METHODS: This study was a prospective, single-centre, phase II, feasibility study. From February to July 2021, 20 patients were enrolled in this study. All patients underwent preoperative three-dimensional computed tomography angiography and bronchography using simulation software. The dominant pulmonary artery of the targeted segment was selected to determine the dissection line and measure the surgical margin to the tumour. Intraoperatively, after the planned dissection of the pulmonary artery, ICG (0.3 mg/kg) was administered intravenously and observed with NIR, and dissection was performed along the line determined by preoperative simulation. Postoperatively, the pathological margin was compared with the simulation margin. RESULTS: All surgeries were performed via an uniport (3.5–4.0-cm skin incision). The regions of segmentectomy were S2, S3, S6, S9 + 10 and S10 of the right side and S1 + 2 + 3, S3, S3 + 4 + 5, S6 and S8 of the left side. The difference between the simulation margin and the pathological margin was not significant (simulation 30.5 ± 10.1 vs pathological 31.0 ± 11.0 mm, P = 0.801). The simulation margin was well correlated with the pathological margin (R(2) = 0.677). The proportion of cases successfully achieving the pathological margin of error of plus or minus 10 mm of the simulation margin was 90% (18 of 20 cases). CONCLUSIONS: The combination of preoperative three-dimensional computed tomography simulation and ICG–NIR was effective for securing a sufficient margin in segmentectomy.
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spelling pubmed-92975032022-07-21 Novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green Matsuura, Natsumi Igai, Hitoshi Ohsawa, Fumi Numajiri, Kazuki Kamiyoshihara, Mitsuhiro Interact Cardiovasc Thorac Surg Thoracic OBJECTIVES: The aim of this study is to assess prospectively the validity and feasibility of segmentectomy using preoperative simulation and intravenous indocyanine green (ICG) with near-infrared (NIR) light thoracoscope to ensure a sufficient surgical margin. METHODS: This study was a prospective, single-centre, phase II, feasibility study. From February to July 2021, 20 patients were enrolled in this study. All patients underwent preoperative three-dimensional computed tomography angiography and bronchography using simulation software. The dominant pulmonary artery of the targeted segment was selected to determine the dissection line and measure the surgical margin to the tumour. Intraoperatively, after the planned dissection of the pulmonary artery, ICG (0.3 mg/kg) was administered intravenously and observed with NIR, and dissection was performed along the line determined by preoperative simulation. Postoperatively, the pathological margin was compared with the simulation margin. RESULTS: All surgeries were performed via an uniport (3.5–4.0-cm skin incision). The regions of segmentectomy were S2, S3, S6, S9 + 10 and S10 of the right side and S1 + 2 + 3, S3, S3 + 4 + 5, S6 and S8 of the left side. The difference between the simulation margin and the pathological margin was not significant (simulation 30.5 ± 10.1 vs pathological 31.0 ± 11.0 mm, P = 0.801). The simulation margin was well correlated with the pathological margin (R(2) = 0.677). The proportion of cases successfully achieving the pathological margin of error of plus or minus 10 mm of the simulation margin was 90% (18 of 20 cases). CONCLUSIONS: The combination of preoperative three-dimensional computed tomography simulation and ICG–NIR was effective for securing a sufficient margin in segmentectomy. Oxford University Press 2022-03-03 /pmc/articles/PMC9297503/ /pubmed/35237828 http://dx.doi.org/10.1093/icvts/ivac064 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Thoracic
Matsuura, Natsumi
Igai, Hitoshi
Ohsawa, Fumi
Numajiri, Kazuki
Kamiyoshihara, Mitsuhiro
Novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green
title Novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green
title_full Novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green
title_fullStr Novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green
title_full_unstemmed Novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green
title_short Novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green
title_sort novel thoracoscopic segmentectomy combining preoperative three-dimensional image simulation and intravenous administration of indocyanine green
topic Thoracic
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297503/
https://www.ncbi.nlm.nih.gov/pubmed/35237828
http://dx.doi.org/10.1093/icvts/ivac064
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