Contribution of fluorescence imaging to thoracoscopic anatomical segmentectomy: a multicenter propensity matching analysis.

Autor:	Wu F; Ward 1 of Thoracic Surgery Department, Anhui Chest Hospital, Hefei, China., Tao X; Ward 1 of Thoracic Surgery Department, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, China., Wang A; Thoracic Surgery Department, the First Affiliated Hospital of Bengbu Medical University, Bengbu, China., Ge Q; Thoracic Surgery Department, the First Affiliated Hospital of Bengbu Medical University, Bengbu, China., Lampridis S; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK., Maurizi G; Department of Thoracic Surgery, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy., Bongiolatti S; Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy., Ong BH; Department of Cardiothoracic Surgery, National Heart Centre Singapore, Singapore, Singapore., Ma D; Ward 1 of Thoracic Surgery Department, Anhui Chest Hospital, Hefei, China., Wang B; Ward 1 of Thoracic Surgery Department, Anhui Chest Hospital, Hefei, China.
Jazyk:	angličtina
Zdroj:	Journal of thoracic disease [J Thorac Dis] 2024 Aug 31; Vol. 16 (8), pp. 5299-5313. Date of Electronic Publication: 2024 Aug 28.
DOI:	10.21037/jtd-24-986
Abstrakt:	Background: Thoracoscopic anatomical segmentectomy is increasingly recognized for managing early-stage lung cancer. However accurately identifying intersegmental planes (ISPs), especially in complex lung segments, remains challenging. In comparison to conventional methods, fluorescence imaging represents a novel solution. This study aimed to examine the potential benefits of fluorescence imaging in single-port thoracoscopic anatomical segmentectomy. Methods: A multicenter (three regional hospitals), retrospective, comparative analysis was conducted using data from 402 consecutive patients who underwent single-port thoracoscopic anatomical segmentectomy from June 2020 to December 2022. The cohort included 191 patients treated with the fluorescence method and 211 patients treated with the modified inflation-deflation method. Among the cohort, 130 patients were placed in the simple segmentectomy group and 272 in the complex segmentectomy group. Propensity score matching (PSM) was used to adjust for baseline differences between the fluorescence and modified inflation-deflation subgroups in the complex segmentectomy group. Perioperative outcomes were compared between the groups. Results: In the simple segmentectomy group, no significant differences were observed between the fluorescence and modified inflation-deflation methods regarding segmental resection time, intraoperative blood loss, postoperative chest tube drainage and duration, postoperative pain, length of hospital stay, complication rate, or hospital costs. In the complex segmentectomy group, however, fluorescence imaging significantly shortened segmental resection time (69.37±28.22 vs . 78.80±34.66 min; P=0.03), while reducing intraoperative blood loss (P=0.046); and improving visual analogue scale (VAS) pain scores on the first postoperative day (P=0.006). Both methods demonstrated comparable safety and oncologic effectiveness. Conclusions: Fluorescence-guided single-port thoracoscopic anatomical segmentectomy demonstrated comparable perioperative safety and effectiveness to the modified inflation-deflation technique while offering advantages, such as shorter segmental resection time, for complex segmentectomies. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-24-986/coif). B.H.O. reports honoraria from AstraZeneca, Bristol-Myers Squibb, Medtronic, MSD and Roche, and meeting support from MSD, outside the submitted work. The other authors have no conflicts of interest to declare. (2024 Journal of Thoracic Disease. All rights reserved.)
Databáze:	MEDLINE
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