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Yujiro Kubo
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P1.16 - Surgery (ID 702)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Surgery
- Presentations: 2
- Moderators:
- Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P1.16-023 - A Useful and Safe Method of Intraoperative Localization of Small-Sized Peripheral Pulmonary Lesions (ID 10457)
09:30 - 09:30 | Presenting Author(s): Yujiro Kubo
- Abstract
Background:
Percutaneous computed tomography(CT)-guided marking is a useful method of intraoperative localization of small-sized peripheral pulmonary lesions. However, severe complications may be caused by visceral pleura puncture. Therefore, we report the safe method without visceral pleura puncture.
Method:
The subjects were from November 2016 to May 2017, 6 males and 5 females, average age 70.7 years (59-86 years), total 11 cases of 12 lesions; 6 cases on the right (1 case: 2 lesions in the same lobe) ยท 5 cases on the left. Before the operation, with the CT-guided , marking on the body surface near the lesion was performed. In cases where ports can be inserted at the marking section, we inserted the ports with both lung ventilation and marked directly on the lung surface. On the other hand, in case of difficult to insert, first we punctured a venous indwelling needle from the marking point and indwelled the outer tube. Second, with both lung ventilation, we inserted a infant nutrition catheter with crystal violet on the tip, and marked the lung surface. Third, we localized the lesion by palpation using marking as an index with partial lung ventilation. And finally, lung partial resection was performed.
Result:
We were able to localize the lesions in all cases, the average operation time was 80 minutes (37 to 147 minutes), and there were no complications during the perioperative period. The resected lesion had an average diameter of 8.8 mm (3 to 16 mm).
Conclusion:
Our method is considered to be quite useful and safe in intraoperative localization of small-sized peripheral pulmonary lesions.
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P1.16-024 - A Case of Bronchial Atresia Treated with Complete Thoracoscopy-Assisted Right S6 Segmentectomy Using Fluorescence Navigation (ID 10471)
09:30 - 09:30 | Author(s): Yujiro Kubo
- Abstract
Background:
Bronchial Atresia is a congenital anomaly of the tracheobronchial tree and often pointed out as an incidental finding on routine examinations. Bronchial atresia often complicates tumor at abnormal lung segment. However it is very difficult to obtain a diagnosis of such a tumor. Because there are no bronchi into the tumor and lung tissue occurs emphysematous changes around the tumor, we can not perform bronchoscopy and computed tomography (CT) guided lung biopsy. Thus, it is important to resect abnormal lung segment clearly. Although there are several reports about imaging findings and treatment for bronchial atresia, they often do not mention about detail surgical procedure. Here we report the case of a 24 year old man with bronchial atresia successfully treated with anatomical pulmonary resection using fluorescence navigation with indocyanine green (ICG) by video-assisted thoracic surgery (VATS).
Method:
Case: A 24 year man pointed out abnormal shadow by chest X-ray in health check. A CT scan of the chest was performed and revealed limited emphysematous changes and tumor at right lower lobe superior segment (S6). According to the previous reports, our preoperative diagnosis was bronchial atresia and proposed operation was right S6 segmentectomy. Methods: The initial part of the procedure, we confirmed pulmonary artery, vein and bronchus of S6 and cut off. ICG was then injected into the peripheral vein catheter by anesthesiologist and the thoracoscope visual system changed to fluorescence mode. Tissue with blood flow appeared green within 30 to 40 seconds after ICG injection. Although perfused lung parenchyma appeared green, the isolated segment remained uncolored.
Result:
We could remove this segment with endoscopic staplers. Pathological diagnosis of removal tumor was granuloma and not cause of obstruction. After 6 months from the operation, CT scan shows no emphysematous changes lesion in right lung.
Conclusion:
Segmentectomy using fluorescence navigation with ICG is useful procedure to resect congenital bronchial atresia.
