[Segmentectomy for Lung Cancer Using Indocyanine Green( ICG)]

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Medical Imaging

Context:

• Segmentectomy for lung cancer requires precise suture line establishment and minimizing local recurrence at resection margins.
• Traditional methods for margin assessment include bronchial dominance and blood flow indicators.
• Intravenous indocyanine green (ICG) fluorescence imaging has emerged as a novel technique for intraoperative margin assessment.

Purpose:

• To evaluate the efficacy of intravenous indocyanine green (ICG) fluorescence imaging in guiding segmentectomy for lung cancer.
• To assess the accuracy of ICG in identifying resection margins and reducing local recurrence.
• To present a retrospective review of cases utilizing ICG for lung cancer segmentectomy.

Summary:

• The study retrospectively reviewed 16 cases of lung cancer (clinical stage I) treated with segmentectomy using ICG fluorescence imaging since January 2020.
• After resection of the pulmonary artery, vein, and bronchus, ICG is injected intravenously, and margins are identified via thoracoscope based on fluorescent and non-fluorescent areas.
• Pulmonary blood flow is re-assessed after initial resection with additional ICG administration, allowing for further resection if margins are contaminated. No recurrence was observed in the reviewed cases.

Impact:

• The ICG fluorescence system demonstrates significant potential in improving the accuracy of lung cancer segmentectomy.
• This technique aids in achieving clear resection margins, thereby reducing the risk of local recurrence.
• The findings support the utility of ICG as a valuable tool in oncologic lung surgery, potentially enhancing patient outcomes.