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OA15 - Sublobar Resections for Early Stage NSCLC (ID 396)
- Event: WCLC 2016
- Type: Oral Session
- Track: Surgery
- Presentations: 1
OA15.06 - The Efficacy of Lung Volume Analyzer for Measuring Resection Margin in Pulmonary Segmentectomy for Malignant Diseases (ID 4055)
16:00 - 17:30 | Author(s): T. Toyoda
Although the confirmation of an appropriate resection margin from the tumor is crucial for reducing the risk of local recurrence after lung segmentectomy for pulmonary malignancies, there has been no method of measurement. We established a novel approach for performing segmentectomy by using an infrared thoracoscopy with transbronchial instillation of indocianine green (ICG), and improved this method by adding an advanced computer technology via lung volume analyzer for obtaining an appropriate resection margin.
Preoperatively, each patient underwent multislice enhanced computed tomography (CT) using 320-slice scanners for pulmonary angiography and virtual bronchoscopy, and to create several virtual segmentectomies by using Volume Analyzer Synapse VINCENT (Fujifilm co., Tokyo, Japan). We measured the shortest distance from the tumor to the resection margin in each simulated segmentectomy and selected the most appropriate area of sublobar resection based on the adequate resection margin of approximately 2 cm from the tumor. We prospectively performed segmentectomy in 17 patients and compared between simulated distance and actual distance measured from the specimen.
The average number of created patterns of virtual segmentectomy in each case was 4.1 ± 1.0. The mean distance of resection margin in selected virtual segmentectomy was 19.3 ± 9.7 mm. On the other hand, actual shortest distance in resected specimen was 25.4 ± 8.1 mm, which was significantly longer than simulated distance (p=0.027). There was no tumor recurrence in all patients.
Lung volume analyzer was an excellent tool for selecting an ideal area of sublobar resection with an appropriate resection margin.
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