Evaluation of the Residual Lung Function After Thoracoscopic Segmentectomy Compared With Lobectomy

Tane, Shinya; Nishio, Wataru; Nishioka, Yuki; Tanaka, Hiroki; Ogawa, Hiroyuki; Kitamura, Yoshitaka; Takenaka, Daisuke; Yoshimura, Masahiro

doi:10.1016/j.athoracsur.2019.05.052

Cited by 66 publications

(74 citation statements)

References 16 publications

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“…Segmentectomy is fundamentally a more limited parenchymal resection and is being advocated for earlystage lung cancer. Several clinical studies have shown that the long-term e cacy of segmentectomy for early NSCLC with a diameter of less than 2 cm is similar to that of lobectomy, with more lung function preserved (3). The advantages of segmentectomy could be preservation of lung function with low frequency of surgical morbidity and mortality, especially for patients with compromised lung function.…”

Section: Discussionmentioning

confidence: 99%

“…With the popularization of low dose computed tomography screening, the epidemiological characteristics of lung cancer have changed greatly (2). Segmentectomy is recommended for surgical treatment of early stage lung cancer, especially for patients with limited pulmonary function preserved (3). One of the most important factors for segmentectomy is to identify the accurate intersegmental plane, which is particularly important to ensure su cient distance between the cutting edges and lesion (4).…”

Section: Introductionmentioning

confidence: 99%

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Near-Infrared intraoperative imaging with indocyanine green is feasible in segmentectomy for patients with chronic lung diseases: A retrospective single-center propensity-score matched analysis

Liu¹,

Yang²,

Cao³

2020

Preprint

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Abstract Objective To investigate whether video-assisted thoracoscopic segmentectomy using near-infrared fluorescence imaging had better intersegmental plane visualization and peri-operative outcome in patients with chronic lung diseases. Methods Data were collected retrospectively from March 2014 and August 2019. A total of 92 patients with pulmonary nodules underwent near-infrared fluorescence guided uni-port thoracoscopic segmentectomy(NIF-VATS), 149 patients underwent thoracoscopic segmentectomy with inflation-deflation method(ID-VATS). After 1:1 propensity matching, perioperative outcomes between NIF-VATS and ID-VATS was compared. Results Incision size was 3 cm in both group.Mean operative time was 79 minutes in NIF-VATS group and 96 minutes in ID-VATS group. The intersegmental plane was not clear in 33 cases of ID-VATS group, and no clear boundary was found after prolonged waiting time. Emphysema or pulmonary bullae could be found in chest CT scan in these patients, they all were diagnosed as chronic obstructive pulmonary disease. In NIF-VATS group, the intersegmental plane was not clear in 8 cases. Under the guidance of three-dimensional reconstruction and preoperative positioning, the oncological margin length of both groups met the requirements of surgical quality control. The intraoperative blood loss, number of lymph node resection, showed no statistical difference between the two groups. Postoperative air leakage was more often observed in ID-VATS group. The postoperative drainage duration, postoperative hospitalization time was shorter in ID-VATS group. Conclusions Compared with inflation-deflation method, segmentectomy using NIF imaging is feasible for patients with chronic lung diseases with better intersegmental plane, shorter operation time, less complications, it might lead to faster recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Near-Infrared intraoperative imaging with indocyanine green is feasible in segmentectomy for patients with chronic lung diseases: A retrospective single-center propensity-score matched analysis

Liu¹,

Yang²,

Cao³

2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Although thoracic surgeons are still awaiting the long-term results of ongoing prospective clinical studies, previous reports have shown favorable oncological outcomes of anatomical segmentectomy for early-stage non-small cell lung cancer, especially lesions that appear radiologically as a ground-glass nodule [ 1 – 4 ]. Compared with lobectomy, which has long been the gold standard treatment for lung cancer, segmentectomy offers various advantages, including preservation of lung parenchyma and respiratory function [ 2 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Hybrid technique of virtual-assisted lung mapping and systemic indocyanine green injection for extended segmentectomy

2020

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Background Various approaches have been used to assist and facilitate segmentectomy with favorable oncological outcomes. We describe a hybrid approach comprising virtual-assisted lung mapping (VAL-MAP), which is a preoperative bronchoscopic dye-marking technique, combined with systemic indocyanine green (ICG) injection. Clinical presentation An asymptomatic 64-year-old man was referred to our department because of a lung nodule detected during his annual medical checkup. The chest computed-tomography image revealed a 16-mm, partly solid, ground-glass nodule in the left segment 4. Because the nodule was hardly palpable and deeply located between the left upper division segment and the left lingular segment, we performed VAL-MAP to facilitate extended left lingulectomy. Five dye markings were undertaken preoperatively. Surgery to remove the nodule was then conducted via complete three-port video-assisted thoracic surgery. The VAL-MAP markings were easily identified intraoperatively and helped locate the nodule. The intersegmental plane was identified by the ICG injection. The resection line was determined based on the intersegmental plane identified by the ICG injection and the site of the nodule suggested by the VAL-MAP markings. Following the resection line, we thoracoscopically achieved extended lingulectomy with sufficient surgical margins. The patient was discharged with no complications. The pathological diagnosis was adenocarcinoma in situ. Conclusion The hybrid technique of VAL-MAP and systemic ICG injection can be useful for accomplishing successful extended segmentectomy.

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“…2) Segmentectomy also has the advantage of preservation of lung function. 2,3) Segmentectomy requires a higher degree of skill than lobectomy for thoracic surgeons. 1) Moreover, segmentectomy is often challenging when thoracic surgeons encounter anatomical anomalies during surgery.…”

Section: Introductionmentioning

confidence: 99%

Left apicoposterior segmentectomy for lung cancer with displaced segmental bronchus: A case report

Yanagiya

Yamaguchi

Hiyama

et al. 2020

Preprint

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Background Pulmonary segmentectomy can be challenging when thoracic surgeons encounter anatomical anomalies. A displaced left apicoposterior bronchus is a rare bronchial anomaly that makes lung anatomical resection challenging. We herein present a case of successful left apicoposterior segmentectomy for lung cancer in a patient with an anomalous segmental bronchus. Case presentation A 70-year-old man was clinically diagnosed with early-stage lung cancer for which segmentectomy was indicated. A preoperative image revealed a displaced left apicoposterior bronchus that branched behind the left main pulmonary artery. With the aid of three-dimensional reconstruction imaging and systemic indocyanine green injection, we successfully performed left apicoposterior segmentectomy under complete video-assisted thoracic surgery. The pathological diagnosis was adenocarcinoma. The patient was alive without recurrence 8 months after segmentectomy. Conclusion Preoperative three-dimensional imaging and systemic indocyanine green injection enabled us to successfully conduct challenging segmentectomy in a patient with an anomalous bronchus.

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Evaluation of the Residual Lung Function After Thoracoscopic Segmentectomy Compared With Lobectomy

Cited by 66 publications

References 16 publications

Near-Infrared intraoperative imaging with indocyanine green is feasible in segmentectomy for patients with chronic lung diseases: A retrospective single-center propensity-score matched analysis

Near-Infrared intraoperative imaging with indocyanine green is feasible in segmentectomy for patients with chronic lung diseases: A retrospective single-center propensity-score matched analysis

Hybrid technique of virtual-assisted lung mapping and systemic indocyanine green injection for extended segmentectomy

Left apicoposterior segmentectomy for lung cancer with displaced segmental bronchus: A case report

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