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Comparison of various lung intersegmental plane identification methods.

Ken Onodera1, Jun Suzuki2, Tomohiro Miyoshi2

  • 1Department of Thoracic Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. kenken1027jp@gmail.com.

General Thoracic and Cardiovascular Surgery
|October 17, 2022
PubMed
Summary

Accurate identification of the intersegmental plane is crucial for preventing recurrence in lung segmentectomy. Systemic indocyanine green injection and the pure oxygen method show high potential for improved identification rates.

Keywords:
Indocyanine greenIntersegmental planeLungSegmentectomy

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Achieving adequate surgical margins is critical in lung segmentectomy to prevent local tumor recurrence.
  • Accurate identification of the intersegmental plane is essential for obtaining these margins.
  • Traditional methods like inflation-deflation have limitations.

Purpose of the Study:

  • To review and evaluate various methods for identifying the intersegmental plane during lung segmentectomy.
  • To compare their identification rates, advantages, and disadvantages.

Main Methods:

  • Review of six primary methods: inflation-deflation, selective segmental inflation, endobronchial dye injection, virtual-assisted lung mapping, systemic indocyanine green injection, and pure oxygen method.
  • Classification of methods based on anatomical (bronchi, pulmonary arteries) or technical (air, dye) approaches.

Main Results:

  • All reviewed methods demonstrated relatively high intersegmental plane identification rates.
  • Systemic indocyanine green injection and the pure oxygen method are expected to yield particularly high identification rates.
  • Each method possesses distinct advantages and disadvantages, necessitating situational selection.

Conclusions:

  • Effective selection and application of intersegmental plane identification methods are vital for successful lung segmentectomy.
  • Further refinement and improvement of existing and novel techniques are required for optimal clinical outcomes.