Image-guided video-assisted thoracoscopic small lung tumor resection using near-infrared marking

Image-guided video-assisted thoracoscopic small lung tumor resection using near-infrared marking Background Localization of non-visible, non-palpable small pulmonary nodules during video-assisted thoracoscopic surgery (VATS) remains challenging. We sought to investigate the feasibility and safety of image-guided video-assisted thoracoscopic surgery (iVATS) with near-infrared (NIR) marking in a hybrid operating room (OR). Methods Both localization and surgery were performed by a single team of thoracic surgeons. Diluted indocyanine green (ICG; quantity: 0.3–0.5 mL; dye concentration: 0.125 mg/mL) was injected percutaneously to pinpoint the tumor’s location under cone beam computed tomography (CBCT) guidance using a laser-guided navigation system. Real-time fluorescence images were intraoperatively obtained using a NIR thoracoscopic camera to guide subsequent resection. Results Between March and December 2017, 26 patients underwent NIR marking of small pulmonary nodules for iVATS. The median tumor size was 7 mm (interquartile range [IQR] 5.3–10.8 mm), whereas their median distance from the pleural surface was 5 mm (IQR 0.3–10.5 mm). Seven nodules (35%) were solid, whereas 17 (65%) were ground-glass opacities. All lesions were identifiable on intraoperative CBCT. The median time required for NIR localization was 13 min. An NIR(+) “tattoo” was identified in all cases, and no intraoperative conversion to thoracotomy occurred. The final pathological diag- noses were primary lung cancer (n = 11), metastatic cancer (n = 6), and benign lung tumor http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Surgical Endoscopy Springer Journals

Image-guided video-assisted thoracoscopic small lung tumor resection using near-infrared marking

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Surgery; Gynecology; Gastroenterology; Hepatology; Proctology; Abdominal Surgery
ISSN
0930-2794
eISSN
1432-2218
D.O.I.
10.1007/s00464-018-6252-7
Publisher site
See Article on Publisher Site

Abstract

Background Localization of non-visible, non-palpable small pulmonary nodules during video-assisted thoracoscopic surgery (VATS) remains challenging. We sought to investigate the feasibility and safety of image-guided video-assisted thoracoscopic surgery (iVATS) with near-infrared (NIR) marking in a hybrid operating room (OR). Methods Both localization and surgery were performed by a single team of thoracic surgeons. Diluted indocyanine green (ICG; quantity: 0.3–0.5 mL; dye concentration: 0.125 mg/mL) was injected percutaneously to pinpoint the tumor’s location under cone beam computed tomography (CBCT) guidance using a laser-guided navigation system. Real-time fluorescence images were intraoperatively obtained using a NIR thoracoscopic camera to guide subsequent resection. Results Between March and December 2017, 26 patients underwent NIR marking of small pulmonary nodules for iVATS. The median tumor size was 7 mm (interquartile range [IQR] 5.3–10.8 mm), whereas their median distance from the pleural surface was 5 mm (IQR 0.3–10.5 mm). Seven nodules (35%) were solid, whereas 17 (65%) were ground-glass opacities. All lesions were identifiable on intraoperative CBCT. The median time required for NIR localization was 13 min. An NIR(+) “tattoo” was identified in all cases, and no intraoperative conversion to thoracotomy occurred. The final pathological diag- noses were primary lung cancer (n = 11), metastatic cancer (n = 6), and benign lung tumor

Journal

Surgical EndoscopySpringer Journals

Published: Jun 4, 2018

References

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