초록접수 현황
| 19F-144 | 구연 발표 |
Dual Visualization of Pulmonary Nodule and Intersegmental Plane under Fluorescent Images during Pulmonary Segmentectomy
Hyun Koo Kim, Yeasul Kim, Kook Nam Han, Jeong In Hong, Young Ho Choi
Departments of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
Purpose : We developed the technique of visualizing pulmonary nodule and intersegmental plane simultaneously using fluorescent images in order to be able to measure the distance between them intraoperatively.
Methods : The patients who were candidate for pulmonary segmenctomy were consecutively included between Mar. 2016 and Feb. 2019. Computed tomography or electromagnetic bronchoscopic-guided localization with indocyanine green (ICG)-lipiodol mixture was performed at the day of surgery preoperatively. In the midst of surgery, after division of segmental artery, vein, and bronchus to a targeted segment, 0.3~0.5 mg/kg of ICG was injected intravenously. Fluorescent thoracoscope visualized the pulmonary nodule and intersegmental plane simultaneously and then the resection margin could be observed based on the distance between them (Figure 1). The resected pulmonary segments were sent to pathologic department for evaluating the resection margin.
Results : A total of 31 patients (17 male/14 female, age 65.0±9.2 years old) were included in this study. The size of nodules was 1.2±0.5 cm (range, 0.4~2.5) and depth of nodules was 18.2±9.4 mm (range, 6.8~42.0). Identification of nodule and intersegmental plane were visualized on fluoresecent thoracoscope in all patients. The resection margins were more than the size of tumor or 2cm in all cases (2.5±1.2 cm) except one. The resection margin of this patient looked enough on intraoperative view, but adenocarcinoma in situ was involved in the resection margin on pathologic report.
Conclusion : This dual visualization technique using ICG could make ease to measure the distance between pulmonary nodule and intersemental plane during pulmonary segmentectomy.
Methods : The patients who were candidate for pulmonary segmenctomy were consecutively included between Mar. 2016 and Feb. 2019. Computed tomography or electromagnetic bronchoscopic-guided localization with indocyanine green (ICG)-lipiodol mixture was performed at the day of surgery preoperatively. In the midst of surgery, after division of segmental artery, vein, and bronchus to a targeted segment, 0.3~0.5 mg/kg of ICG was injected intravenously. Fluorescent thoracoscope visualized the pulmonary nodule and intersegmental plane simultaneously and then the resection margin could be observed based on the distance between them (Figure 1). The resected pulmonary segments were sent to pathologic department for evaluating the resection margin.
Results : A total of 31 patients (17 male/14 female, age 65.0±9.2 years old) were included in this study. The size of nodules was 1.2±0.5 cm (range, 0.4~2.5) and depth of nodules was 18.2±9.4 mm (range, 6.8~42.0). Identification of nodule and intersegmental plane were visualized on fluoresecent thoracoscope in all patients. The resection margins were more than the size of tumor or 2cm in all cases (2.5±1.2 cm) except one. The resection margin of this patient looked enough on intraoperative view, but adenocarcinoma in situ was involved in the resection margin on pathologic report.
Conclusion : This dual visualization technique using ICG could make ease to measure the distance between pulmonary nodule and intersemental plane during pulmonary segmentectomy.
책임저자: Hyun Koo Kim
Departments of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
발표자: Hyun Koo Kim, E-mail : kimhyunkoo@korea.ac.kr