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Recent fluorescence-based optical imaging for video-assisted thoracoscopic surgery segmentectomy.

Yosuke Matsuura1, Mingyon Mun1, Junji Ichinose1

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Annals of Translational Medicine
|March 12, 2019
PubMed
Summary

Indocyanine-green fluorescence (ICGF) navigation for near-infrared (NIR) thoracoscopic segmentectomy is feasible and effective. This technique enhances visualization during lung cancer surgery, showing a 98% visibility rate and excellent long-term patient outcomes.

Keywords:
Video-assisted thoracoscopic surgery (VATS)indocyanine green (ICG)near-infrared thoracoscopy (NIR thoracoscopy)segmentectomy

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Area of Science:

  • Surgical Oncology
  • Medical Imaging
  • Thoracic Surgery

Background:

  • Fluorescence-based optical imaging is increasingly vital in surgical applications.
  • This study investigates indocyanine-green fluorescence (ICGF) navigation for near-infrared (NIR) thoracoscopic segmentectomy.

Purpose of the Study:

  • To assess the feasibility and efficacy of ICGF-based navigation in NIR thoracoscopic segmentectomy.
  • To evaluate the safety and long-term outcomes of this surgical approach.

Main Methods:

  • A prospective cohort study involving 149 patients undergoing ICGF-based VATS segmentectomy.
  • Preoperative 3D MDCT simulations guided the procedure, with low-dose ICG injected after vascular and bronchial division.
  • NIR thoracoscopic guidance was used to delineate and divide lung parenchyma.

Main Results:

  • ICGF-based intersegmental lines were visible in 98% of patients, even with low-dose ICG.
  • No ICG-related adverse events or major procedure-related complications were observed.
  • Five-year overall survival (OS) and recurrence-free survival (RFS) rates were 91.8% and 98%, respectively, with no local recurrence.

Conclusions:

  • ICGF-based navigation is a feasible and effective technique for NIR VATS segmentectomy in lung cancer patients.
  • The method demonstrates high visibility, safety, and positive long-term oncological outcomes.