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Rudondy Q, Frey S, Bentellis I, Benkirane T, Cohen C, Benzaquen J, Ilie M, Gomez‐Caro A, Berthet J. Impact of indocyanine green on prolonged air leak in minimally invasive segmentectomy. Thorac Cancer 2024; 15:994-1006. [PMID: 38494909 PMCID: PMC11045334 DOI: 10.1111/1759-7714.15274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Video-assisted thoracoscopic segmentectomies have become the gold standard for the treatment of early-stage non-small cell lung cancer less than two centimeters. The main difficulty is the identification of intersegmental boundary lines which dictate postoperative morbidities. METHODS We conducted a retrospective study to compare the perioperative outcomes of patients who underwent minimally invasive segmentectomy using the traditional deflation-inflation method or the novel indocyanine green (ICG) technique. Using a prospectively maintained database, we performed a retrospective analysis of 197 consecutive anatomical segmentectomies, from 2020 to 2023. Clinical effectiveness, postoperative complications, and histological data were compared. RESULTS A total of 73 (37%) patients had the inflation-deflation method and 124 (63%) had the intravenous ICG method. There were no significant differences in chest tube duration, prolonged air leak, postoperative complications, and postoperative hospital stays. Surgical margin width was also similar between the two groups. The multivariable analysis confirmed these results. Lastly, intravenous ICG brought no additional value in complex segmentectomies. CONCLUSION This monocentric and retrospective analysis found no added value of the intravenous ICG on the perioperative results of minimally invasive segmentectomies. The place of this novel technique in the surgical armamentarium remains to be defined. Specific indications such as complex segmentectomy or patients with chronic pulmonary disease require further study.
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Affiliation(s)
- Quentin Rudondy
- University of Cote d'AzurNiceFrance
- Department of Thoracic Surgery, Pasteur 1 HospitalUniversity Hospital of NiceNiceFrance
| | - Sebastien Frey
- University of Cote d'AzurNiceFrance
- Department of General Surgery, Pasteur 2 HospitalUniversity Hospital of NiceNiceFrance
| | - Imad Bentellis
- University of Cote d'AzurNiceFrance
- Department of Urology, Pasteur 2 HospitalUniversity Hospital of NiceNiceFrance
| | - Tayeb Benkirane
- University of Cote d'AzurNiceFrance
- Department of Thoracic Surgery, Pasteur 1 HospitalUniversity Hospital of NiceNiceFrance
| | - Charlotte Cohen
- Department of Thoracic Surgery, Pasteur 1 HospitalUniversity Hospital of NiceNiceFrance
| | - Jonathan Benzaquen
- University of Cote d'AzurNiceFrance
- Department of Pneumology, Pasteur 1 HospitalUniversity Hospital of NiceNiceFrance
| | - Marius Ilie
- University of Cote d'AzurNiceFrance
- Department of Pathology, Pasteur 2 HospitalUniversity Hospital of NiceNiceFrance
| | - Abel Gomez‐Caro
- Department of Thoracic Surgery, Pasteur 1 HospitalUniversity Hospital of NiceNiceFrance
| | - Jean‐Phillippe Berthet
- University of Cote d'AzurNiceFrance
- Department of Thoracic Surgery, Pasteur 1 HospitalUniversity Hospital of NiceNiceFrance
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Tacconi F, Mangiameli G, Voulaz E, Patirelis A, Carlea F, Rocca EL, Tamburrini A, Vanni G, Ambrogi V. Blood-Derived Systemic Inflammation Markers and Risk of Nodal Failure in Stage Ia Non-Small Cell Lung Cancer: A Multicentric Study. J Clin Med 2023; 12:4912. [PMID: 37568316 PMCID: PMC10419646 DOI: 10.3390/jcm12154912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Unexpected spread to regional lymph nodes can be found in up to 10% of patients with early stage non-small cell lung cancer (NSCLC), thereby affecting both prognosis and treatment. Given the known relation between systemic inflammation and tumor progression, we sought to evaluate whether blood-derived systemic inflammation markers might help to the predict nodal outcome in patients with stage Ia NSCLC. METHODS Preoperative levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation score (SII, platelets × NLR) were collected from 368 patients who underwent curative lung resection for NSCLC. After categorization, inflammatory markers were subjected to logistic regression and time-event analysis in order to find associations with occult nodal spread and postoperative nodal recurrence. RESULTS No inflammation marker was associated with the risk of occult nodal spread. SII showed a marginal effect on early nodal recurrence at a quasi-significant level (p = 0.065). However, patients with T1c tumors and elevated PLR and/or SII had significantly shorter times to nodal recurrence compared to T1a/T1b patients (p = 0.001), while patients with T1c and normal PLR/SII did not (p = 0.128). CONCLUSIONS blood-derived inflammation markers had no value in the preoperative prediction of nodal status. Nevertheless, our results might suggest a modulating effect of platelet-derived inflammation markers on nodal progression after the resection of tumors larger than 2 cm.
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Affiliation(s)
- Federico Tacconi
- Thoracic Surgery and Breast Unit, Department of Surgical Sciences, Tor Vergata University Polyclinic, Viale Oxford 81, 00133 Rome, Italy; (A.P.); (F.C.); (E.L.R.); (G.V.); (V.A.)
| | - Giuseppe Mangiameli
- Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.M.); (E.V.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Emanuele Voulaz
- Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy; (G.M.); (E.V.)
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Alexandro Patirelis
- Thoracic Surgery and Breast Unit, Department of Surgical Sciences, Tor Vergata University Polyclinic, Viale Oxford 81, 00133 Rome, Italy; (A.P.); (F.C.); (E.L.R.); (G.V.); (V.A.)
| | - Federica Carlea
- Thoracic Surgery and Breast Unit, Department of Surgical Sciences, Tor Vergata University Polyclinic, Viale Oxford 81, 00133 Rome, Italy; (A.P.); (F.C.); (E.L.R.); (G.V.); (V.A.)
| | - Eleonora La Rocca
- Thoracic Surgery and Breast Unit, Department of Surgical Sciences, Tor Vergata University Polyclinic, Viale Oxford 81, 00133 Rome, Italy; (A.P.); (F.C.); (E.L.R.); (G.V.); (V.A.)
| | - Alessandro Tamburrini
- Unit of Cardio-thoracic Surgery, Southampton General Hospital, Tremona Road, Southampton SO166YD, UK;
| | - Gianluca Vanni
- Thoracic Surgery and Breast Unit, Department of Surgical Sciences, Tor Vergata University Polyclinic, Viale Oxford 81, 00133 Rome, Italy; (A.P.); (F.C.); (E.L.R.); (G.V.); (V.A.)
| | - Vincenzo Ambrogi
- Thoracic Surgery and Breast Unit, Department of Surgical Sciences, Tor Vergata University Polyclinic, Viale Oxford 81, 00133 Rome, Italy; (A.P.); (F.C.); (E.L.R.); (G.V.); (V.A.)
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