Related Experiment Video
Updated: Aug 11, 2025
Laparoscopic Anatomical Hepatectomy Using Takasaki's Approach and Indocyanine Green Fluorescence Navigation
Published on: May 16, 2025
[Thoracoscopic Segmentectomy Using Three-dimensional Image Simulation of the Pulmonary Artery Perfusion Area and
Takuya Nagashima1, Hiroyuki Ito, Hiroyuki Adachi
1Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Purpose:
When performing segmentectomy, we aim to keep adequate distance from the tumor using three-dimensional( 3D) images of the pulmonary artery perfusion area and the indocyanine green( ICG) injection method. The effectiveness and improvement of this method were examined.
Patients And Method:
We retrospectively investigated 50 consecutive patients who underwent segmentectomy with this method. In simulation, we measured the predicted margin distance( PMD) on a 3D image. Then, we measured the actual margin distance (AMD) on resected specimens fixed in formalin. We compared these two distances and evaluated factors influencing shorter AMD.
Results:
The median AMD was 1.7 cm, and there was no positive margin case. The median ratio of AMD/PMD was 0.73. In multivariate analysis, shorter PMD and no resection of subsegment bronchi next to the tumor were significant factors associated with shorter AMD( p<0.001, p=0.014).
Conclusions:
Our method was effective for segmentectomy. For adequate AMD, a longer PMD in simulation and subsegmental bronchi resection next to the tumor should be considered.
