Near-infrared mapping with indocyanine green is associated with an increase in oncological margin length in minimally invasive segmentectomy

The Journal of Thoracic and Cardiovascular Surgery
Meera MehtaWaël C Hanna

Abstract

Near-infrared fluorescence mapping with indocyanine green dye is a recent advancement in minimally invasive segmental resection. This technique has not yet been reproduced, validated, or objectively evaluated in a large prospective case series. We hypothesized that near-infrared fluorescence mapping is associated with an increased oncological margin distance from the tumor, over and above the best judgment of the surgeon. This was a phase 2 prospective cohort trial in patients who are undergoing robotic segmentectomy for lung tumors <3 cm. The predicted intersegmental plane was first identified by consensus between 2 thoracic surgeons. The true plane was then mapped by indocyanine green injection. A 7-item binary rating scale was used for the evaluation of feasibility, reproducibility, and added oncological margin distance from the tumor. The margin distance between the tumor and the true plane was compared with the margin distance between the tumor and the predicted plane. Fifty-three patients were enrolled between September 2016 and May 2018 and 31 patients (58.4%) received the planned operation with indocyanine green mapping. In 74.2% of cases (23 out of 31), a score of 7 out of 7 was achieved, indicating the true intersegme...Continue Reading

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References

Sep 21, 2010·The Journal of Thoracic and Cardiovascular Surgery·Noriyuki MisakiHiroyasu Yokomise
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Aug 24, 2013·The Annals of Thoracic Surgery·Sukki ChoSanghoon Jheon
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Citations

Aug 27, 2019·Frontiers in Surgery·Dana Ferrari-LightRobert J Cerfolio
Apr 17, 2021·The Thoracic and Cardiovascular Surgeon·Xingshi ChenHecheng Li
Feb 19, 2019·The Journal of Thoracic and Cardiovascular Surgery·Moishe Liberman
Aug 20, 2021·Journal of Surgical Case Reports·Mikio OkazakiShinichi Toyooka
Aug 27, 2021·Interactive Cardiovascular and Thoracic Surgery·Hirohisa KatoSatoshi Takamori

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