Abstract:

Objective To investigate the feasibility and safety of indocyanine green fluorescent staining method for thoracoscopic anatomical lung segmentectomy. Methods Patients who underwent thoracoscopic anatomical lung segmentectomy in our hospital from January 2024 to May 2025 were divided into experimental group （n = 112） and control group （n = 98）. Patients in the experimental group were adopted the indocyanine green fluorescent staining method in defining the intersegmental plane. Patients in the control group were adopted inflation-deflation method. There were no statistical differences between the two groups in sex， age， smoking history， COPD history， target lung segment， size of pulmonary nodules， CTR value of pulmonary nodules and nature of pulmonary nodules （P > 0.05）. Surgery and complications in both groups were retrospectively analyzed. Results Surgery： Intraoperative blood loss ［（74.2 ± 13.8）mL vs. （74.9 ± 15.4）mL， P = 0.674］， pleural adhesion ［（11.6% vs. 17.3%， P = 0.236］， the number of lymph node dissection ［（2.0 ± 0.8） groups vs. （2.0 ± 0.8） groups， P = 0.965］， distance from nodule and margin ［（3.0 ± 1.5）cm vs. （3.0 ± 1.4）cm， P = 0.667］， the time in hospital after operation ［（3.5 ± 1.2）d vs. （3.5 ± 1.2）d， P = 0.721］ in the experimental group and control group without any statistically difference. However， there were statistically significant differences between two groups in the operation time ［（87.4 ± 14.1）min vs. （100.7 ± 14.3）min， P < 0.001］ and the time of intersegment plane appearance ［（11.0 ± 2.0）s vs. （962.7 ± 101.3）s， P < 0.001］. and the duration of the intersegment plane in the experimental group was （103.4 ± 37.4）s. The R0 resection rate of pulmonary nodules was 100% in both groups. Complications： Two groups had no statistical differences in the incidence of hemoptysis （8.9% vs. 8.2%， P = 0.843）， atelectasis （4.5% vs. 6.1%， P = 0.591）， pulmonary infection （3.6% vs. 9.2%， P = 0.092）， arrhythmia （2.7% vs. 7.1%， P = 0.130）， and persistent pulmonary air leakage （10.7% vs. 16.3%， P = 0.233）. Conclusion Compared with the traditional inflation-deflation method， indocyanine green fluorescent staining method can quickly， accurately and clearly display the intersegment plane， shorten the operation time， and provide reliable technical support for thoracoscopic anatomical lung segment resection. It is a safe and feasible method， worthy of application in clinical practice.

Key words: indocyanine green, thoracoscope, segmentectomy, lung cancer