[Thoracoscopic Segmentectomy Using Three-dimensional Image Simulation of the Pulmonary Artery Perfusion Area and Indocyanine Green( ICG) Intravenous Injection Method].

PURPOSE: When performing segmentectomy, we aim to keep adequate distance from the tumor using three-dimensional( 3D) images of the pulmonary artery perfusion area and the indocyanine green( ICG) injection method. The effectiveness and improvement of this method were examined.

PATIENTS AND METHOD: We retrospectively investigated 50 consecutive patients who underwent segmentectomy with this method. In simulation, we measured the predicted margin distance( PMD) on a 3D image. Then, we measured the actual margin distance (AMD) on resected specimens fixed in formalin. We compared these two distances and evaluated factors influencing shorter AMD.

RESULTS

The median AMD was 1.7 cm, and there was no positive margin case. The median ratio of AMD/PMD was 0.73. In multivariate analysis, shorter PMD and no resection of subsegment bronchi next to the tumor were significant factors associated with shorter AMD( p<0.001, p=0.014).

CONCLUSIONS

Our method was effective for segmentectomy. For adequate AMD, a longer PMD in simulation and subsegmental bronchi resection next to the tumor should be considered.