Segmentectomy is a targeted surgical approach tailored for patients with compromised health and early-stage lung cancer. The key to successful segmentectomy lies in precisely identifying the tumor and intersegmental planes to ensure adequate resection margins. In this study, we aimed to enhance this process by simultaneously visualizing the tumor and intersegmental planes through the intravenous injection of indocyanine green (ICG) at different time points and doses. Lung tumors were detected by intravenous injection of ICG at a dose of 2 mg/kg 12 h before surgery in a rabbit model. Following the dissection of the pulmonary artery, vein, and bronchi of the target segment, 0.6 mg/kg of ICG was injected intravenously to detect the intersegmental plan. Fluorescent images of the lung tumors and segments were acquired, and the fluorescent signal was quantified using the signal-to-background ratio (SBR). Finally, a pilot study of this method was conducted in three patients with lung cancer. In a preclinical study, the SBR of the tumor (4.4 ± 0.1) and nontargeted segments (10.5 ± 0.8) were significantly higher than that of the targeted segment (1.6 ± 0.2) (targeted segment vs. nontarget segment,p< 0.0001; target segment vs. tumor,p< 0.01). Consistent with preclinical results, lung tumors and the intersegmental plane were successfully detected in patients with lung cancer. Consequently, adequate resection margins were identified during the surgery, and segmentectomy was successfully performed in patients with lung cancer. This study is the first to use intravenous ICG injections at different time points and doses to simultaneously detect lung cancer and intersegmental planes, thereby achieving segmentectomy for lung cancer.
肺段切除术是针对健康状况欠佳且处于肺癌早期阶段患者的一种精准外科手术方式。成功实施肺段切除术的关键在于精确定位肿瘤及段间平面，以确保足够的切除边界。本研究旨在通过在不同时间点及剂量下静脉注射吲哚菁绿（ICG），实现对肿瘤与段间平面的同步可视化，从而优化手术流程。在兔模型中，术前12小时以2 mg/kg剂量静脉注射ICG成功检测到肺部肿瘤。在离断目标肺段的肺动脉、肺静脉及支气管后，静脉注射0.6 mg/kg剂量的ICG以识别段间平面。研究获取了肺部肿瘤及肺段的荧光图像，并通过信背比（SBR）对荧光信号进行量化分析。最终，该方法在三例肺癌患者中开展了初步临床研究。临床前研究显示，肿瘤区域（4.4 ± 0.1）与非目标肺段（10.5 ± 0.8）的SBR值均显著高于目标肺段（1.6 ± 0.2）（目标肺段与非目标肺段对比p<0.0001；目标肺段与肿瘤对比p<0.01）。与临床前结果一致，该方法在肺癌患者中成功实现了肺部肿瘤与段间平面的同步检测。术中据此确定了充分的切除边界，成功为肺癌患者实施了肺段切除术。本研究首次通过不同时间点及剂量的静脉ICG注射方案，实现了肺癌与段间平面的同步可视化，从而成功完成肺癌肺段切除术。
肿瘤(癌症)患者之家