Application Of Indocyanine Green Fluorescence Staining In Thoracoscopic Segmentectomy

Objective At present,low-dose Spiral CT(LDCT)has been widely used in clinical examination,and many patients with pulmonary nodules have been detected.Surgical operation is the main intervention method for pulmonary nodules with high malignant possibility.Studies have shown that anatomical pulmonary segmentectomy for early stage Ia non-small cell lung cancer(NSCLC)is comparable to lobectomy and can protect lung function to the greatest extent and improve postoperative quality of life.However,for anatomical pulmonary segmentectomy,the operative difficulty lies in the accurate display of the mid-segment plane.In this study,the advantages and related problems of fluorescence staining in thoracoscopic anatomical pulmonary segmentectomy were analyzed by comparing the application effects of fluorescence staining and modified expansion collapse method in thoracoscopic anatomical pulmonary segmentectomy.Methods The clinical data of 66 patients with pulmonary nodules who underwent thoracoscopic anatomical segmentectomy in the Department of Thoracic Surgery of our hospital from January 2019 to May 2020 were retrospectively analyzed.According to defined section plane method is different,between the 66 patients were divided into two groups,including fluorescent dye group as the experimental group of 26 cases,modified expansive atelectatic group as control group 40 cases,statistical perioperative patients with clinical data were analyzed,including: two groups of patients with basic information collection(age,gender,pulmonary function index),tumor size,operative time,intraoperative blood loss,number of lymph node cleaning,postoperative chest tube indwelling time,postoperative hospital stay,postoperative complications(lung infection,continuous leakage(> 3 days),blood in phlegm,pleural effusion),and observed two groups of patients who appeared between the middle plane of time.Results In the fluorescence group,surgery time(min)was shorter than that one from modified inflation-deflation group[(185.77±45.58)min vs(213.13±45.71)min,P=0.021].Compared with the modified inflation-deflation group,the fluorescence group showed shorter display time[10.00(9.00,12.00)min vs 750.00(705.25,1300.00)min,P<0.001].They were so statistically significant.There were no obvious diversities in bleeding volume,the number of lymph node dissection,drainage time,hospitalization time and morbidity between these two groups(all P > 0.05).Conclusion Compared with the modified expansion and collapse method,the indocyanine green fluorescent staining method can quickly and intuitively display the inter-segment plane during anatomical lung resection,and effectively complete the inter-segment marking,effectively shorten the operation time,and is worthy of clinical promotion.