Determination of accurate surgical margin using indocyanine green (ICG) and near infrared spectroscopy in thoracic surgery.

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We performed twenty-four cases (male/21, female/3), and SN localization were identified in 19(79.17%) cases by fluorescence method. Accurate identification of sentinel node were 17 out of 19 (89.47%). Each one case of pN1 and pN2, sentinel lymph node (lobar, interlobar) and metastatic lymph node (hilar, subsegmental ) were different. It is suggested that the lymph pathway had been changed due to lymph node metastasis to subsegmental and hilar. Otherwise the lymph pathway from subsegmental to hilar was filled with tumor cells, so ICG could not arrive at hilar. The novel technique indicates efficient lymph node identification in lung cancer. To establish the strategy of sentinel lymph node navigation surgery in lung cancer, we need further studies and analysis.We investigated 19 cases of bulla and detected the surgical margin. Positive surgical margin were estimated 13 cases, and negative were 6 cases. Giant bulla cases and 8 out of 14 cases (57.1%) of pneumothorax showed positive surgical margin. Consistence with pathological surgical margin was 84.2%. It is considered that estimation of surgical margin during the operation by fluorescence method were effective.