New clinically applicable method for visualizing adjacent lung segments using an infrared thoracoscopy system
New clinically applicable method for visualizing adjacent lung segments using an infrared thoracoscopy system
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DOI：
10.1016/j.jtcvs.2010.07.020
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发表时间：
2010-10-01
影响因子：
6
通讯作者：
Yokomise, Hiroyasu
中科院分区：
文献类型：
--
作者：
Misaki, Noriyuki;Chang, Sung Soo;Yokomise, Hiroyasu
目的：探讨静脉注射吲哚青绿后应用红外胸镜系统行肺段切除术的临床应用价值。所有人都计划接受节段切除，并已被证实对碘或吲哚青绿不过敏。所有患者均征得知情同意。我们利用重建的计算机断层扫描图像确定了供应靶段的主要肺动脉。结扎靶段优势肺动脉，静脉注射吲哚青绿(3.0 mg/kg)后，用红外胸腔镜系统观察肺组织，电灼法标记白蓝过渡带，行肺段切除。结果：平均手术时间150±62.1分钟，出血量68.8±30.5毫升。在红外胸腔镜下，注射吲哚青绿13s后，血供正常的区域染成蓝色。染料注入后28s达到最大染色强度，观察时间为3.5min。在所有患者中都观察到了明确的颜色分区。我们有足够的时间来标记它。结论：红外胸腔镜结合吲哚青绿可以方便、快速地识别靶肺段，而不需要充气。这种方法对于与严重肺气肿相关的病例或手术视野有限的病例特别有用，就像电视辅助胸部手术一样。(《胸心外科杂志》2010；140：752-6)
Objective: Our objective was to attempt a clinical trial of segmentectomy using the infrared thoracoscopy system after intravenous injection of indocyanine green.Patients and Methods: A total of 8 patients with lung lesions were investigated (5 with primary lung cancer, 2 with metastatic lung tumor, and 1 with inflammatory change). All were scheduled to undergo segmentectomy and had been confirmed to have no allergy to iodine or indocyanine green. Informed consent was obtained from all patients. We identified the dominant pulmonary artery supplying the target segment using reconstructed computed tomography images. The dominant pulmonary artery of the target segment was ligated, and after we had observed the lung using the infrared thoracoscopy system after intravenous injection of indocyanine green (3.0 mg/kg), and marked the white-to-blue transitional zone by electrocautery, we performed segmentectomy.Results: Average operation time was 150 +/- 62.1 minutes, and bleeding volume was 68.8 +/- 30.5 mL. Under infrared thoracoscopy, the area with a normal blood supply became stained blue 13 seconds after injection of indocyanine green. Maximum staining intensity was attained 28 seconds after dye injection, and the observation duration was 3.5 minutes. A well-defined color zonation was observed in all patients. We had enough time to mark it. No complications attributable to infrared thoracoscopy after intravenous injection of indocyanine green were encountered.Conclusions: Infrared thoracoscopy with indocyanine green makes it possible to identify the target lung segment easily and quickly without the need for inflation. This method will be especially useful for cases associated with severe emphysema or when surgery offers a limited view, as is the case with video-assisted thoracic surgery. (J Thorac Cardiovasc Surg 2010;140:752-6)