Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Comparative Study of Indocyanine Green Intravenous Injection and the Inflation-Deflation Method for Assessing Resection Margins in Segmentectomy for Lung Cancer: A Single-Center Retrospective Study

  • Seon Yong Bae (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Taeyoung Yun (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Ji Hyeon Park (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Bubse Na (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Kwon Joong Na (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Samina Park (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Hyun Joo, Lee (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • In Kyu Park (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Chang Hyun Kang (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital) ;
  • Young Tae Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital)
  • Received : 2024.01.16
  • Accepted : 2024.02.29
  • Published : 2024.09.05
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Abstract

Background: The inflation-deflation (ID) method has long been the standard for intraoperative margin assessment in segmentectomy. However, with advancements in vision technology, the use of near-infrared mapping with indocyanine green (ICG) has become increasingly common. This study was conducted to compare the perioperative outcomes and resection margins achieved using these methods. Methods: This retrospective study included patients who underwent direct segmentectomy for clinical stage I lung cancer between January 2018 and September 2022. We compared perioperative factors, including bronchial and parenchymal resection margins, according to the margin assessment method and the type of segmentectomy performed. Since the ICG approach was adopted in April 2021, we also examined a recent subgroup of patients treated from then onward. Results: A total of 319 segmentectomies were performed. ID and ICG were utilized for 261 (81.8%) and 58 (18.2%) patients, respectively. Following April 2021, 61 patients (51.3%) were treated with ID, while 58 (48.7%) received ICG. We observed no significant difference in resection margins between ID and ICG for bronchial (2.7 cm vs. 2.3 cm, p=0.07) or parenchymal (2.5 cm vs. 2.3 cm, p=0.46) margins. Additionally, the length of hospitalization and the complication rate were comparable between groups. Analysis of the recent subgroup confirmed these findings, showing no significant differences in resection margins (bronchial: 2.6 cm vs. 2.3 cm, p=0.25; parenchymal: 2.4 cm vs. 2.3 cm, p=0.75), length of hospitalization, or complication rate. Conclusion: The perioperative outcomes and resection margins achieved using ID and ICG were comparable, suggesting that both methods can safely guide segmentectomy procedures.

Keywords

Acknowledgement

This work was supported by Research Program 2023, funded by the Seoul National University College of Medicine Research Foundation (800-20230541).

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