Author of

• 20180

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  P2.16 - Surgery (ID 717)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23535

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    P2.16-004 - Alternative Subpreural Lymph Flow Pathways in Human Lung – a Hundred Cases Experience and Analysis (ID 8352)

    09:30 - 09:30  |  Presenting Author(s): Takuya Tokunaga
    • Abstract

    Background:
    Pulmonary lymph flows are predominantly regarded to run along bronchi. In addition, limited resections such as segmentectomy are increasing recently. However there are some cases suggesting alternative lymph pathways, such as the skip metastases. We herein observed pleural lymph flows by the indocyanine green (ICG) fluorescence method with a near-infrared camera device in patients who underwent lung resections.
    
    Method:
    After thoracotomy, we injected ICG to subpleural spaces of the lung lobe that planned to resect in 100 cases. Intraoperative fluorescence images were observed in real time using a near-infrared camera. Patients with pleural involvement were excluded.
    
    Result:
    In 58 out of 100 cases, ICG movements were observed in subpleural space. In 18 cases, ICG flowed into adjacent lobes over the interlobular line. In 5 cases, ICG flowed into the mediastinum directly. Subpreural lymph flow detection rates were significantly lower in patients with smoking pack-year >40 than those with pack-years <40.
    
    Conclusion:
    In our study, in more than half of the cases, pleural lymph flows were observed and there were lymph flows that flowed into the mediastinum directly. In addition, the reduction of subpleural lymph flows in smokers with >40 pack-year suggests that smoking might modify lymph flow patterns. In the future, these findings may help us to select appropriate procedures for patients with possible skip metastasis.