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セキネ ヤスオ
SEKINE YASUO
関根 康雄 所属 医学部 医学科（附属八千代医療センター） 職種 客員教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Precise anatomical sublobar resection using a 3D medical image analyzer and fluorescence-guided surgery with transbronchial instillation of indocyanine green. |
| 掲載誌名 | 正式名：Seminar Thoracic and Cardiovasclar Surgery 略 称：Semin Thorac Cardiovasc Surg ISSNコード：1092-9126 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 31(3),pp.595-602 |
| 著者・共著者 | Sekine Yasuo, Koh Eitetsu, Hoshino Hidehisa |
| 担当区分 | 筆頭著者,責任著者 |
| 発行年月 | 2019/01/05 |
| 概要 | We developed a novel approach combined with 3D image analyzer and infrared thoracoscopy for pulmonary sublobar resection. The purpose of this study was to investigate the feasibility of this procedure. From October 2014 to April 2018, 65 cases were enrolled, and 58 cases were evaluated. For each case, several virtual sublobar resections were created by 3D image analyzer preoperatively. The surgical margin was measured in each simulated sublobar resection and the most appropriate procedure was selected. Surgical resection with matching virtual sublobar resection was performed using infrared thoracoscopy with transbronchial indocyanine green (ICG) instillation. We evaluated the border clarity of ICG fluorescence to investigate success of ICG injection and compared pre- and postoperative CTs to determine whether the correct area could be removed according to the simulation. We also compared short-term surgical outcomes between the ICG cases and historical segmentectomy cases by propensity score matching. The success rate of transbronchial ICG injections was 89.2% (58/65). These 58 patients were eligible for evaluation of our procedure. Sublobar resection included subsegmental resection (5), simple segmentectomy (15), complex segmentectomy (16), and extended segmentectomy (22). The shortest distances to the surgical margin by simulation and by actual measurement were 21.5 ± 11.2 mm and 23.5 ± 8.3, respectively (P = 0.190). Fifty-four of 58 cases underwent sublobar resection matched with the simulation (93.1% concordance rate). Operative results and short-term outcomes were similar between the 2 groups by propensity score matching. ICG-guided sublobar resection by transbronchial ICG instillation is feasible and applicable to any type of sublobar resection. |
| DOI | 10.1053/j.semtcvs.2019.01.004 |