Naoya Yokota, Tetsuhiko Go, Atsushi Fujiwara, Ayumu Kato, Yasuhiro Otsuki, Hiroyasu Yokomise
BACKGROUND: Efficient methods for the detection and repair of pleural defects are crucial for preventing postoperative air leaks; however, there are few studies on sealing test methods. We developed a new sealing test method that involves the administration of aerosolized indocyanine green into the airway. This experimental study aimed to confirm whether this method could identify alveolar-pleural fistulas. METHODS: Thoracotomy was performed on six beagles under general anesthesia...
July 17, 2020: Annals of Thoracic Surgery
Gianluca Perroni, Giulia Veronesi
Use of low-dose CT scan allows detection of lung cancer at early stages, enabling a more conservative surgery and a better long-term survival in those patients. In this scenario, intentional anatomical segmentectomy is gaining consent over standard lobectomy among surgeons. A minimally invasive approach such as VATS reduced invasiveness and complication rate compared to open surgery, but this technique comes also with some disadvantages in terms of dexterity and intuitiveness. Robotic surgery allows to overcome those limitations, making segmentectomies easier and safer to perform...
June 2020: Journal of Thoracic Disease
Giulia Nex, Marcella Schiavone, Angela De Palma, Rosatea Quercia, Debora Brascia, Giulia De Iaco, Francesca Signore, Teodora Panza, Giuseppe Marulli
Pulmonary segmentectomy is a common surgical procedure in thoracic surgery nowadays. Though this technique helps preventing postoperative pulmonary function loss, potential challenges are the management of air leaks and the difficulty of palpating ground-glass components during surgery, as well as how to deal with the intersegmental planes. Several techniques have been proposed for the identification and treatment of the intersegmental planes during sublobar anatomical resections: this review focuses on preoperative planning and workup and intraoperative strategies...
June 2020: Journal of Thoracic Disease
Takaaki Hasegawa, Hiroaki Kuroda, Shohei Chatani, Yuichiro Furuya, Yozo Sato, Hiroaki Iwamasa, Tsubasa Asai, Hideki Yashiro, Shigeru Matsushima, Yoshitaka Inaba
Background: Although a mixture of pigments and radiopaque materials was reported to be useful material for lung nodule localization, the optimal combination has not been well investigated. The purpose of this study is to evaluate the characteristics of various combinations of pigments and radiopaque materials for localization of pulmonary nodules prior to video-assisted thoracic surgery (VATS). Methods: We compared stability, viscosity, and visibility of 6 radiopaque dye materials of (I) mixture of indigo carmine and lipiodol; (II) mixture of indigo carmine, lipiodol, and lidocaine gel; (III) mixture of indocyanine green in water solution (w-ICG) and lipiodol; (IV) mixture of w-ICG, lipiodol, and lidocaine gel; (V) ICG in contrast medium solution (cm-ICG); and (VI) mixture of cm-ICG and lidocaine gel...
May 2020: Journal of Thoracic Disease
Kyeong Cheol On, Jiyun Rho, Hong Yeol Yoon, Hyeyoun Chang, Ji Young Yhee, Jun Sik Yoon, Seo Young Jeong, Hyun Koo Kim, Kwangmeyung Kim
Theranostic nanoparticles can deliver therapeutic agents as well as diverse imaging agents to tumors. The enhanced permeation and retention (EPR) effect is regarded as a crucial mechanism for the tumor-targeted delivery of nanoparticles. Although a large number of studies of the EPR effect of theranostic nanoparticles have been performed, the effect of the change in the body size of the host on the EPR effect is not fully understood. In this regard, comparative research is needed on the behavior of nanoparticles in large animals for developing the nanoparticles to the clinical stage...
July 3, 2020: Pharmaceutics
Toyofumi F Chen-Yoshikawa, Takayuki Fukui, Shota Nakamura, Toshinari Ito, Yuka Kadomatsu, Hideki Tsubouchi, Harushi Ueno, Tomoshi Sugiyama, Masaki Goto, Shunsuke Mori, Naoki Ozeki, Shuhei Hakiri, Koji Kawaguchi
Thoracic surgery has evolved drastically in recent years. Although thoracic surgeons mainly deal with tumorous lesion in the lungs, mediastinum, and pleura, they also perform lung transplantation surgery in patients with end-stage lung disease. Herein, we introduce various major current topics in thoracic surgery. Minimally invasive surgical procedures include robot-assisted thoracic surgery and uniportal video-assisted thoracic surgery. Novel techniques for sublobar resection include virtual-assisted lung mapping, image-guided video-assisted thoracic surgery, and segmentectomy using indocyanine green...
May 2020: Nagoya Journal of Medical Science
Yu Hua Quan, Chan Hee Oh, Daeho Jung, Ji-Young Lim, Byeong Hyeon Choi, Jiyun Rho, Yeonho Choi, Kook Nam Han, Beop-Min Kim, Chungyeul Kim, Ji-Ho Park, Hyun Koo Kim
Importance: Identification of the tumor margin during surgery is important for precise minimal resection of lung tumors. Intravenous injection of indocyanine green (ICG) has several limitations when used for intraoperative visualization of lung cancer. Objectives: To describe a technique for intraoperative visualization of lung tumor margin using ICG inhalation and evaluate the clinical applicability of the technique in mouse and rabbit lung tumor models as well as lung specimens of patients with lung tumors...
June 24, 2020: JAMA Surgery
Gongming Wang, Yongbin Lin, Kongjia Luo, Xiaodan Lin, Lanjun Zhang
BACKGROUND: It is a great challenge for surgeons to resect pulmonary nodules with small volume, deep position and no solid components under video-assisted thoracoscopic surgery. The purpose of this study is to explore the feasibility and necessity of the localization of pulmonary nodules by injecting indocyanine green (ICG) under the guidance of magnetic navigation bronchoscope and the resection of small pulmonary nodules under the fluoroscope. METHODS: Between December 2018 and August 2019, sixteen consecutive patients with 30 peripheral lung lesions in our hospital received fluorescent thoracoscopic pulmonary nodule resection...
June 20, 2020: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Xukai Li, Yuan Zeng, Jun Liu, Fei Cui, Jianxing He
Currently there is no explicit guideline for the use of indocyanine green (ICG) in the localization of pulmonary nodules before surgery. How long ICG can remain in vivo is unknown. According to previous reports, ICG can be observed under infrared thoracoscope within 24 hours after injection. We unexpectedly found a case of a 54-year-old male who was still clearly visible under the infrared thoracoscope after 6 days of CT-guided injection of ICG. This unexpected finding suggests that the operation time can be arranged appropriately after local injection with ICG...
April 30, 2020: Annals of Thoracic Surgery
Shilei Zhao, Xin Guo, Makoto Taniguchi, Kazuya Kondo, Sohsuke Yamada, Chundong Gu, Hidetaka Uramoto
BACKGROUND: The method of quickly identifying metastatic mediastinal lymph nodes has become an urgent problem for lung cancer surgery. Indocyanine green (ICG) has the characteristic of being retained in or around the lymph nodes; its pharmacokinetic characteristics and optimal imaging time have not yet been elucidated. MATERIALS AND METHODS: The IVIS Lumina Imaging System was used to detect near infrared (NIR) fluorescence signals at different ICG doses, times and excitation/emission wavelengths in vitro...
April 2020: Anticancer Research
C Wang, Y Liu, L Yang, S K Liu
Objective: To investigate the effectiveness and safety of CT-guided intrapulmonary injection of indocyanine green (ICG) for preoperative localization of small pulmonary nodules and ground glass opacities. Methods: From October 2018 to July 2019, a total of 34 consecutive patients (39 nodules) who were suspected to be lung cancer and underwent thoracoscopic surgery were enrolled. The size of the nodules was 0.3-2.0 (0.9±0.3) cm, including 6 solid nodules, 9 impure ground glass nodules and 24 pure ground glass nodules...
February 25, 2020: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Avadhesh Oli, Divya Balakrishnan
Purpose: To report a case of localized suprachoroidal hemorrhage presenting as a choroidal mass. Case Report: A 66-year-old woman presented with sudden onset pain in the right eye, one week following uneventful cataract surgery. The best corrected visual acuity (BCVA) was 20/160 and fundus examination showed a brown elevated choroidal mass temporal to the fovea in the right eye with normal retina and retinal vessels over it. The differential diagnoses considered were choroidal granuloma, melanoma, choroidal hemangioma, posterior scleritis, and localized suprachoroidal hemorrhage (SCH)...
January 2020: Journal of Ophthalmic & Vision Research
Allen Li, S Chan, K H Thung
OBJECTIVES: To describe our clinical experience of using combination of fluorescent iodized emulsion, indocyanine green (ICG) & lipiodol, and hook-wire in pre-operative computed tomographic (CT) localization of patients with subsolid lung lesions prior to video-assisted thoracoscopic surgery (VATS). METHODS: A retrospective review between June 2018 and July 2019 of consecutive Chinese patients whom underwent VATS for subsolid lung lesions with preoperative CT localization done with combination of fluorescent iodized emulsion and hook wire technique in a tertiary hospital XX...
February 5, 2020: British Journal of Radiology
Liang Zhong, Weidong Hu, Shuping Li, Zhenhong Wei, Zijiang Zhu, Gang Jin, Hongyi Zhang, Yao Pang, Jun Yu
Aim: This study aimed to assess the clinical effectiveness of video-assisted thoracoscopic surgery (VATS) in early-stage lung cancer by indocyanine green (ICG) for tumor mapping. Material and methods: Thirty patients with early-stage lung cancer with peripheral nodules smaller than 2 cm scheduled for computed tomography (CT)-guided microcoil placement followed by ICG tumor mapping by VATS wedge resection were enrolled. After microcoil deployment, 100 to 150 ml of diluted ICG was injected percutaneously near the nodule...
December 2019: Videosurgery and Other Miniinvasive Techniques
Yungang Sun, Qiang Zhang, Zhao Wang, Feng Shao, Rusong Yang
OBJECTIVES: At present, the modified inflation-deflation method is accepted and widely used in the clinic, but the near-infrared (NIR) fluorescence imaging with intravenous indocyanine green (ICG) method can also delineate the intersegmental demarcation. However, whether the two methods identify that the intersegmental plane is concordant with each other and match the real intersegmental demarcation is still unknown. METHODS: Between March 2019 to July 2019, 19 consecutive segmentectomies were performed, using both methods to delineate the intersegmental plane, in order to evaluate and verify whether the intersegmental plane results created by the two methods were concordant and matched the real intersegmental demarcation...
September 3, 2019: Thoracic Cancer
Nozomu Motono, Shun Iwai, Aika Funasaki, Atsushi Sekimura, Katsuo Usuda, Hidetaka Uramoto
BACKGROUND: The potential complications of pulmonary sequestration are serious and may include recurrent pulmonary infection, hemoptysis, and tumorigenesis. Therefore, the gold standard of treatment has been surgery. Although an adequate boundary between the nonfunctional lung and normal lung is required for the resection of pulmonary sequestration, the boundaries have been conventionally identified intraoperatively with inflation/deflation of the target segment by clamping and unclamping the relevant bronchus...
July 27, 2019: Journal of Medical Case Reports
Takashi Anayama, Kentaro Hirohashi, Hironobu Okada, Ryohei Miyazaki, Marino Yamamoto, Nobutaka Kawamoto, Kazumasa Orihashi
Early stage lung cancers which localized in the middle layer or the center of the lung become indications for anatomical segmentectomy. As a method of intraoperative identifying the intra-segmental plane, 2 different techniques utilizing indocyanine green (ICG) fluorescence has been clinically applied. The one is a method of systemically intravenous administration of ICG after ligating the objective segmental pulmonary artery. The other is a method of insufflate the diluted ICG into the objective segmental bronchus under the bronchoscope...
July 2019: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Ryota Myobatake, Hiroyoshi Tsubochi, Tomoyuki Nakano, Kentaro Minegishi, Shunsuke Endo
BACKGROUND: The most important step in lung segmentectomy is to determine an appropriate intersegmental plane to obtain sufficient pre- and intraoperative margins. Inappropriate dissection of the lung parenchyma leads to loss of oncological validity and additionally causes various complications such as pneumonia, prolonged air leakage, lung congestion, and atelectasis. OBJECTIVES: In this study, we evaluated the validity of segmentectomy for non-small cell lung cancer (NSCLC) based on evaluation of survival outcomes and recurrence patterns...
July 2019: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Norihito Okumura
INTRODUCTIONS: Recently, reports of segmentectomy using indocyanine green (ICG) infrared thoracoscopy is gradually increasing. This method enables the clear identification of intersegmental line without the effect of collateral air drift, and seems useful especially for complex segmentectomy. On the other hand, the division of intersegmental plane using auto stapler recently seems to have some evidence of superiority of avoiding air-leakage over that using electrocautery. For these reasons, we have performed thoracoscopic stapler-based segmentectomy using ICG-infrared thoracoscopy...
July 2019: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Sung Soo Chang, Tetsuhiko Go, Natsumi Matsuura, Takayuki Nakano, Nariyasu Nakashima, Shintaro Tarumi, Hiroyasu Yokomise
OBJECTIVES: Recently, the use of video-assisted thoracoscopic surgery (VATS) segmentectomy for pulmonary malignancies has increased. For non-palpable lesions, securing a sufficient surgical margin is more likely to be uncertain. The purpose of this study was to evaluate the usefulness of our intraoperative navigation system in combination with the infrared thoracoscopy (IRT)-indocyanine green (ICG) method and intraoperative computed tomography (CT) during VATS segmentectomy for non-palpable pulmonary malignancies...
July 2019: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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