Yongsen Li, Yonghao Cao, Yuan Chen, Jing Huang, Kunpeng Feng, Chun Xu, Chang Li, Jun Zhao, Ziqing Shen, Cheng Ding
{"title":"单孔胸腔镜复杂肺段切除术中分水岭分析与吲哚青绿荧光染色法和改良充气-放气法的比较","authors":"Yongsen Li, Yonghao Cao, Yuan Chen, Jing Huang, Kunpeng Feng, Chun Xu, Chang Li, Jun Zhao, Ziqing Shen, Cheng Ding","doi":"10.21037/jtd-24-1075","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The increasing utilization of computed tomography (CT) scans has significantly elevated the detection rate of pulmonary nodules. Pulmonary segmentectomy has become the preferred surgical technique for peripheral non-small cell lung cancer (NSCLC) measuring 2 cm or smaller. Various methods for identifying the intersegmental planes (ISPs) are currently employed. This study aims to compare the short-term clinical safety and efficacy of the watershed analysis with indocyanine green (ICG) fluorescence staining to the modified inflation-deflation method in single-port thoracoscopic complex pulmonary segmentectomy.</p><p><strong>Methods: </strong>This retrospective study was conducted on patients who underwent single-port thoracoscopic complex pulmonary segmentectomy at The First Affiliated Hospital of Soochow University between January 2023 and December 2023. One cohort received treatment with the watershed analysis with ICG fluorescence staining, while the other cohort was treated with the modified inflation-deflation method. The study evaluated intraoperative and postoperative conditions, as well as the short-term impact on postoperative pulmonary function in both groups.</p><p><strong>Results: </strong>The watershed analysis with ICG fluorescence staining group demonstrated less operating time (P<0.001), shorter ISPs visualization time (P<0.001), and reduced intraoperative blood loss (P<0.001). Postoperatively, 8 patients (16%) in this group experienced air leakage, compared to 20 patients (39%) in the modified inflation-deflation method group, indicating significant differences between the groups (P=0.009). Additionally, the watershed analysis with ICG fluorescence staining group had shorter postoperative drainage tube duration (P<0.001), shorter postoperative hospitalization (P<0.001), and less postoperative pleural effusion volume (P<0.001). There was no disparity observed in pulmonary function decline at three months after the surgery between the two cohorts.</p><p><strong>Conclusions: </strong>The watershed analysis with ICG fluorescence staining is associated with less operating time, fewer postoperative complications, and a lower risk of postoperative air leakage in complex pulmonary segmentectomy. The impact on pulmonary function was comparable to the traditional method. These findings suggest that the watershed analysis with ICG fluorescence staining is a more promising, safe, and effective approach for complex pulmonary segmentectomy.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"16 11","pages":"7697-7708"},"PeriodicalIF":2.1000,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635237/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of watershed analysis with indocyanine green fluorescence staining and modified inflation-deflation method in single-port thoracoscopic complex pulmonary segmentectomy.\",\"authors\":\"Yongsen Li, Yonghao Cao, Yuan Chen, Jing Huang, Kunpeng Feng, Chun Xu, Chang Li, Jun Zhao, Ziqing Shen, Cheng Ding\",\"doi\":\"10.21037/jtd-24-1075\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The increasing utilization of computed tomography (CT) scans has significantly elevated the detection rate of pulmonary nodules. Pulmonary segmentectomy has become the preferred surgical technique for peripheral non-small cell lung cancer (NSCLC) measuring 2 cm or smaller. Various methods for identifying the intersegmental planes (ISPs) are currently employed. This study aims to compare the short-term clinical safety and efficacy of the watershed analysis with indocyanine green (ICG) fluorescence staining to the modified inflation-deflation method in single-port thoracoscopic complex pulmonary segmentectomy.</p><p><strong>Methods: </strong>This retrospective study was conducted on patients who underwent single-port thoracoscopic complex pulmonary segmentectomy at The First Affiliated Hospital of Soochow University between January 2023 and December 2023. One cohort received treatment with the watershed analysis with ICG fluorescence staining, while the other cohort was treated with the modified inflation-deflation method. The study evaluated intraoperative and postoperative conditions, as well as the short-term impact on postoperative pulmonary function in both groups.</p><p><strong>Results: </strong>The watershed analysis with ICG fluorescence staining group demonstrated less operating time (P<0.001), shorter ISPs visualization time (P<0.001), and reduced intraoperative blood loss (P<0.001). Postoperatively, 8 patients (16%) in this group experienced air leakage, compared to 20 patients (39%) in the modified inflation-deflation method group, indicating significant differences between the groups (P=0.009). Additionally, the watershed analysis with ICG fluorescence staining group had shorter postoperative drainage tube duration (P<0.001), shorter postoperative hospitalization (P<0.001), and less postoperative pleural effusion volume (P<0.001). There was no disparity observed in pulmonary function decline at three months after the surgery between the two cohorts.</p><p><strong>Conclusions: </strong>The watershed analysis with ICG fluorescence staining is associated with less operating time, fewer postoperative complications, and a lower risk of postoperative air leakage in complex pulmonary segmentectomy. The impact on pulmonary function was comparable to the traditional method. These findings suggest that the watershed analysis with ICG fluorescence staining is a more promising, safe, and effective approach for complex pulmonary segmentectomy.</p>\",\"PeriodicalId\":17542,\"journal\":{\"name\":\"Journal of thoracic disease\",\"volume\":\"16 11\",\"pages\":\"7697-7708\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-11-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635237/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of thoracic disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/jtd-24-1075\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-24-1075","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Comparison of watershed analysis with indocyanine green fluorescence staining and modified inflation-deflation method in single-port thoracoscopic complex pulmonary segmentectomy.
Background: The increasing utilization of computed tomography (CT) scans has significantly elevated the detection rate of pulmonary nodules. Pulmonary segmentectomy has become the preferred surgical technique for peripheral non-small cell lung cancer (NSCLC) measuring 2 cm or smaller. Various methods for identifying the intersegmental planes (ISPs) are currently employed. This study aims to compare the short-term clinical safety and efficacy of the watershed analysis with indocyanine green (ICG) fluorescence staining to the modified inflation-deflation method in single-port thoracoscopic complex pulmonary segmentectomy.
Methods: This retrospective study was conducted on patients who underwent single-port thoracoscopic complex pulmonary segmentectomy at The First Affiliated Hospital of Soochow University between January 2023 and December 2023. One cohort received treatment with the watershed analysis with ICG fluorescence staining, while the other cohort was treated with the modified inflation-deflation method. The study evaluated intraoperative and postoperative conditions, as well as the short-term impact on postoperative pulmonary function in both groups.
Results: The watershed analysis with ICG fluorescence staining group demonstrated less operating time (P<0.001), shorter ISPs visualization time (P<0.001), and reduced intraoperative blood loss (P<0.001). Postoperatively, 8 patients (16%) in this group experienced air leakage, compared to 20 patients (39%) in the modified inflation-deflation method group, indicating significant differences between the groups (P=0.009). Additionally, the watershed analysis with ICG fluorescence staining group had shorter postoperative drainage tube duration (P<0.001), shorter postoperative hospitalization (P<0.001), and less postoperative pleural effusion volume (P<0.001). There was no disparity observed in pulmonary function decline at three months after the surgery between the two cohorts.
Conclusions: The watershed analysis with ICG fluorescence staining is associated with less operating time, fewer postoperative complications, and a lower risk of postoperative air leakage in complex pulmonary segmentectomy. The impact on pulmonary function was comparable to the traditional method. These findings suggest that the watershed analysis with ICG fluorescence staining is a more promising, safe, and effective approach for complex pulmonary segmentectomy.
期刊介绍:
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.