Efficacy of Near-Infrared Fluorescence Video-Assisted Thoracoscopic Surgery for Small Pulmonary Nodule Resection with Indocyanine Green Inhalation: A Randomized Clinical Trial

doi:10.1245/s10434-023-13753-4

	Efficacy of Near-Infrared Fluorescence Video-Assisted Thoracoscopic Surgery for Small Pulmonary Nodule Resection with Indocyanine Green Inhalation: A Randomized Clinical Trial
	Wang, Kun 1,2; Huang, Weiyuan 1; Chen, Xianshan 3; Li, Gao 3; Li, Na4 ; Huang, Xiuming 3; Liao, Xuqiang 3; Song, Jiali 1; Yang, Qianyu 1; He, Kunshan5 ; An, Yu 5; Feng, Xin2 ; Zhang, Zeyu5 ; Chi, Chongwei2 ; Tian, Jie 1,5; Chen, Fengxia 3; Chen, Feng 1
发表期刊	ANNALS OF SURGICAL ONCOLOGY
ISSN	1068-9265
	2023-06-30
页码	11
通讯作者	Tian, Jie(jie.tian@ia.ac.cn) ; Chen, Fengxia(chenfengxia0073@126.com) ; Chen, Feng(fenger0802@163.com)
摘要	Background. Small pulmonary nodules (<3 cm) can sometimes be unrecognizable and nonpalpable in video-assisted thoracoscopic surgery (VATS). Near-infrared fluorescence (NIF) VATS after indocyanine green (ICG) inhalation may effectively guide surgeons to locate the nodules. Objective. This study aimed to investigate the safety, feasibility, and efficacy of ICG inhalation-based NIF imaging for guiding small pulmonary nodule resections. Methods. Between February and May 2021, the first-stage, non-randomized trial enrolled 21 patients with different nodule depth, ICG inhalation doses, post-inhalation surgery times, and nodule types at a tertiary referral hospital. Between May 2021 and May 2022, the second-stage randomized trial enrolled 56 patients, who were randomly assigned to the fluorescence VATS (FLVATS) or the white-light VATS (WLVATS) group. The ratio of effective guidance and the time consumption for nodule localization were compared. Results. The first-stage trial proved this new method is safe and feasible, and established a standardized protocol with optimized nodule depth (<= 1 cm), ICG dose (0.20-0.25 mg/kg), and surgery window (50-90 min after ICG inhalation). In the second-stage trial, the FLVATS achieved 87.1% helpful nodule localization guidance, which was significantly higher than the WLVATS (59.1%, p < 0.05). The mean nodule locating time (standard deviation) was 1.8 [0.9] and 3.3 [2.3] min, respectively. Surgeons adopting FLVATS were significantly faster (p < 0.01), especially when locating small ground-glass opacities (1.3 [0.6] min vs. 7.0 [3.5] min, p < 0.05). Five of 31 nodules (16.1%) were only detectable by FLVATS, whereas both white light and palpation failed. Conclusions. This new method is safe and feasible for small pulmonary nodule resection. It significantly improves nodule localization rates with less time consumption, and hence is highly worthy for clinical promotion.
DOI	10.1245/s10434-023-13753-4
关键词[WOS]	CELL LUNG-CANCER ; METHYLENE-BLUE ; LOCALIZATION ; IDENTIFICATION ; MANAGEMENT
收录类别	SCI
语种	英语
资助项目	Ministry of Science and Technology of China[2017YFA0205200] ; National Natural Science Foundation of China[62027901] ; National Natural Science Foundation of China[81930053] ; National Natural Science Foundation of China[81227901] ; National Natural Science Foundation of China[92159305] ; Excellent Member Project of Youth Innovation Promotion Association CAS[2016124] ; Hainan Province Clinical Medical Center
项目资助者	Ministry of Science and Technology of China ; National Natural Science Foundation of China ; Excellent Member Project of Youth Innovation Promotion Association CAS ; Hainan Province Clinical Medical Center
WOS研究方向	Oncology ; Surgery
WOS类目	Oncology ; Surgery
WOS记录号	WOS:001022111400002
出版者	SPRINGER
引用统计	被引频次：1[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	http://ir.ia.ac.cn/handle/173211/53694
专题	中国科学院分子影像重点实验室
通讯作者	Tian, Jie; Chen, Fengxia; Chen, Feng
作者单位	1.Hainan Med Univ, Hainan Gen Hosp, Dept Radiol, Hainan Affiliated Hosp, Haikou, Hainan, Peoples R China 2.Chinese Acad Sci, Inst Automat, Beijing Key Lab Mol Imaging, Beijing, Peoples R China 3.Hainan Med Univ, Hainan Gen Hosp, Dept Thorac Surg, Hainan Affiliated Hosp, Haikou, Hainan, Peoples R China 4.Hainan Med Univ, Hainan Gen Hosp, Dept Anesthesiol, Affiliated Hainan Hosp, Haikou, Hainan, Peoples R China 5.Beihang Univ, Beijing Adv Innovat Ctr Big Data Based Precis Med, Sch Med & Engn, Beijing, Peoples R China
第一作者单位	中国科学院自动化研究所
推荐引用方式 GB/T 7714	Wang, Kun,Huang, Weiyuan,Chen, Xianshan,et al. Efficacy of Near-Infrared Fluorescence Video-Assisted Thoracoscopic Surgery for Small Pulmonary Nodule Resection with Indocyanine Green Inhalation: A Randomized Clinical Trial[J]. ANNALS OF SURGICAL ONCOLOGY,2023:11.
APA	Wang, Kun.,Huang, Weiyuan.,Chen, Xianshan.,Li, Gao.,Li, Na.,...&Chen, Feng.(2023).Efficacy of Near-Infrared Fluorescence Video-Assisted Thoracoscopic Surgery for Small Pulmonary Nodule Resection with Indocyanine Green Inhalation: A Randomized Clinical Trial.ANNALS OF SURGICAL ONCOLOGY,11.
MLA	Wang, Kun,et al."Efficacy of Near-Infrared Fluorescence Video-Assisted Thoracoscopic Surgery for Small Pulmonary Nodule Resection with Indocyanine Green Inhalation: A Randomized Clinical Trial".ANNALS OF SURGICAL ONCOLOGY (2023):11.