A Pilot Study Of Pulmonary Segmentectomy With Indocyanine Green Near-infrared Angiography

Objectives:Video-assisted thoracoscopic surgery(VATS)pulmonary segmentectomy is commonly used in treating small ground glass opacity(GGO)nodules in lung.The identification of intersegmental plane is one of the challenge.In this pilot study,we aim to evaluate the feasibility of indocyanine green(ICG)angiography in video assisted thoracoscopic surgery segmentectomy.Methods:19 GGO patients were enrolled and VATS segmentectomy with ICG near-infrared angiography were performed between July 2017 and December 2017.Conventional 3-port VATS was used.ICG was injected intravenously after dominant arties were ligated.Intersegmental plane was identified and divided by stapler and electrocautery.Results:All patients had perfect intersegmental plane visualization.The mean operation time was 140.8 minutes and the mean blood loss was 23.7 mL.No complications about ICG happened.The mean chest tube duration was 4.6 days.No severe complications happened in the perioperative period.The mean chest tube drainage duration was 4.6 days.Prolonged postoperative air leak(>5 days),which required no surgical intervention happened in 2 cases.There were no severe complication or in-hospital deaths.Conclusions:VATS segmentectomy with ICG near-infrared angiography is a reasonable treatment option to treat small GGO in lung,especially for its good surgical view maintenance.