Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy

Nomori, Hiroaki; Shiraishi, Atsushi; Cong, Yang; Sugimura, Hiroshi; Mishima, Shuji

doi:10.1093/ejcts/ezx357

Cited by 76 publications

(63 citation statements)

References 30 publications

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“…Segmentectomy is increasingly becoming a popular technique for the treatment of early stage lung cancer as it combines equivalent oncologic requirements and greater preservation of lung function. Multiple studies have shown that there is no difference between segmentectomy compared with lobectomy in the postoperative tumor recurrence rate and five‐year survival rate in the treatment of early stage lung cancer, with considerable oncological outcomes . Segmentectomy is an anatomical resection compared with wedge resection which maintains an adequate surgical margin, preserves the morphology of residual lungs and performs intrapulmonary lymph node sampling, which reduces local recurrence and metastasis of malignant tumors, and improves the accuracy rate of tumor staging …”

Section: Introductionmentioning

confidence: 99%

Is the near‐infrared fluorescence imaging with intravenous indocyanine green method for identifying the intersegmental plane concordant with the modified inflation‐deflation method in lung segmentectomy?

et al. 2019

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Objectives At present, the modified inflation‐deflation method is accepted and widely used in the clinic, but the near‐infrared (NIR) fluorescence imaging with intravenous indocyanine green (ICG) method can also delineate the intersegmental demarcation. However, whether the two methods identify that the intersegmental plane is concordant with each other and match the real intersegmental demarcation is still unknown. Methods Between March 2019 to July 2019, 19 consecutive segmentectomies were performed, using both methods to delineate the intersegmental plane, in order to evaluate and verify whether the intersegmental plane results created by the two methods were concordant and matched the real intersegmental demarcation. Results Segmentectomies were carried out using uniportal video‐assisted thoracic surgery (UVATS) successfully with no intraoperative conversions or ICG‐related complications and only three cases (15.8%) with postoperative complications related to the operation. The intersegmental plane generated by the NIR fluorescence imaging with intravenous ICG method was found to be totally concordant with the modified inflation‐deflation method that was approaching the real intersegmental demarcation in all 19 cases. Conclusions Both methods revealed the intersegmental plane clearly, and the NIR fluorescence imaging with intravenous ICG method was found to be totally concordant with the modified inflation‐deflation method, which is highly concordant with the real intersegmental demarcation. NIR fluorescence imaging with intravenous ICG method may be more popular because of its safety, efficiency, and less complicated restrictions, especially in patients with pulmonary emphysema. Low doses of ICG do not affect the rate of identification of the intersegmental plane and is safer from drug toxicology.

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Section: Introductionmentioning

confidence: 99%

Is the near‐infrared fluorescence imaging with intravenous indocyanine green method for identifying the intersegmental plane concordant with the modified inflation‐deflation method in lung segmentectomy?

et al. 2019

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“…A current meta-analysis, however, elucidated that segmentectomy produced survival rates similar to those obtained by lobectomy for patients with stage I NSCLC (7). Moreover, segmentectomy preserves whole lung function better than lobectomy, because the lobe is not only preserved, but the function of the ipsilateral nonoperated lobe(s) is improved (8). Although the importance of segmentectomy for stage I NSCLC has increased, segmentectomy remains a more difficult procedure than wedge resection or lobectomy.…”

Section: Introductionmentioning

confidence: 94%

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

Matsuura¹,

Mun²,

Ichinose³

et al. 2019

Ann. Transl. Med

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Background: The importance of fluorescence-based optical imaging in various fields of surgery is increasing. This is a prospective cohort study aimed to investigate the feasibility and efficacy of indocyaninegreen fluorescence (ICGF)-based navigation for near-infrared (NIR) thoracoscopic segmentectomy. Methods: ICGF-based video-assisted thoracoscopic surgery (VATS) segmentectomy was performed in 149 patients. Each patient underwent preoperative evaluation by multidetector-row computed tomography (MDCT), which provided three-dimensional simulations of vascular structures, segmental bronchi, and lung tumor. During the procedure, low-dose ICG (0.25 mg/kg) was injected systemically after the target segmental pulmonary arteries and bronchus were divided. Under NIR-thoracoscopic guidance, an ICG fluorescent line was marked by electric scalpel, followed by division of lung parenchyma along the line by electric scalpel or endoscopic staples. Results: An intersegmental line of ICGF was visible in 98% of patients, even with the use of low-dose ICG. Neither ICG-related adverse events nor procedure-related major complications occurred. The 5-year overall (OS) and recurrence-free survival (RFS) rates were 91.8% and 98%, respectively. Localized recurrence at the resected site did not occur in any patient. Conclusions: ICGF-based navigation for NIR VATS segmentectomy for patients with lung cancer is feasible and effective.

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“…Studies have shown that sublobar resection had a good protective effect on patients’ residual lung function. 4 However, the surgical damage evaluation of patients with different surgical methods is inconclusive, and the impact of different lung resections on the short-term outcomes of patients is not yet clear. Considering that adenocarcinoma dominated a great part in lung cancer, the purpose of this study was to retrospectively analyze the short-term outcomes of lung adenocarcinoma patients who underwent different lung resections.…”

Section: Introductionmentioning

confidence: 99%

<p>Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma</p>

Zhang

Bai

Guo

et al. 2020

CMAR

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Background To investigate postoperative temporary consequences of the enrolled patients with lung adenocarcinoma. Patients and Methods We analyzed the clinical data of patients with lung adenocarcinoma admitted by the same surgical team of Peking Union Medical College Hospital (PUMCH) from July 2019 to December 2019. Statistical methods including propensity score matching (PSM) analysis was used to analyze the differences among them. Results A total of 108 patients were enrolled, including 50 patients with sublobar resection and 58 patients with lobectomy. Before PSM, there were statistically significant differences in age ( p =0.015), hospitalization costs ( p =0.042), lymphadenectomy ( p =0.000), pathological staging ( p =0.000), number of lymph nodes removed ( p =0.000), number of positive lymph nodes ( p =0.034), chest drainage duration ( p =0.000), total chest drainage ( p =0.000), length of postoperative hospital stays ( p =0.000), postoperative D-dimer level ( p =0.030) and perioperative lymphocyte margin (LM) ( p =0.003) between sublobar resection and lobectomy. After PSM, there were statistical differences in number of lymph nodes removed ( p =0.000), chest drainage duration ( p =0.031) and total chest drainage ( p =0.002) between sublobar resection and lobectomy. Whether with PSM analysis or not, there were no significant differences in other blood test results, such as inflammation indicators, postoperative neutrophil-lymphocyte ratio (NLR), albumin level, perioperative activity of daily living (ADL) scale scoring margin, complications, postoperative admission to intensive care unit (ICU) and readmission within 30 days. NLR was associated with total chest drainage ( p =0.000), length of postoperative hospital stays ( p =0.000), postoperative D-dimer level ( p =0.050) and ADL scale scoring margin ( p =0.003) between sublobar resection and lobectomy. Conclusion Sublobar resection, including wedge resection and segmentectomy, was as safe and feasible as lobectomy in our study, and they shared similar short-term outcomes. Postoperative NLR could be used to detect the clinical outcomes of patients. Secondary resectability of pulmonary function (SRPF) should be the main purpose of sublobar resection.

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Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy

Cited by 76 publications

References 30 publications

Is the near‐infrared fluorescence imaging with intravenous indocyanine green method for identifying the intersegmental plane concordant with the modified inflation‐deflation method in lung segmentectomy?

Is the near‐infrared fluorescence imaging with intravenous indocyanine green method for identifying the intersegmental plane concordant with the modified inflation‐deflation method in lung segmentectomy?

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

<p>Postoperative Short-term Outcomes Between Sublobar Resection and Lobectomy in Patients with Lung Adenocarcinoma</p>

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