Evaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective study

Abstract Background This study aimed to investigate the feasibility and clinical benefits of indocyanine green (ICG) inhalation for detecting air leak sites during video-assisted thoracoscopic surgery (VATS). Methods Between February 2023 and May 2023, a total of 288 patients underwent VATS were enr...

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Main Authors: Zhenfan Wang, Xue Tian, Zihan Wei, Hao Xu, Kunshan He, Chongwei Chi, Songjing Zhao, Ruiheng Jiang, Fan Yang, Yun Li, Jian Zhou
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-02875-z
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author Zhenfan Wang
Xue Tian
Zihan Wei
Hao Xu
Kunshan He
Chongwei Chi
Songjing Zhao
Ruiheng Jiang
Fan Yang
Yun Li
Jian Zhou
author_facet Zhenfan Wang
Xue Tian
Zihan Wei
Hao Xu
Kunshan He
Chongwei Chi
Songjing Zhao
Ruiheng Jiang
Fan Yang
Yun Li
Jian Zhou
author_sort Zhenfan Wang
collection DOAJ
description Abstract Background This study aimed to investigate the feasibility and clinical benefits of indocyanine green (ICG) inhalation for detecting air leak sites during video-assisted thoracoscopic surgery (VATS). Methods Between February 2023 and May 2023, a total of 288 patients underwent VATS were enrolled in this study. Among the population, 72 patients received ICG inhalation test following the traditional submersion sealing test. And 216 patients only underwent the submersion sealing test were matched using 1:3 propensity score matching analysis. The results of ICG inhalation test and the clinical outcomes were compared. Results In the ICG group, 48 air leak sites were detected in 25 patients (25/72, 34.7%). The conventional submersion sealing test identified 30 air leak sites, while the ICG inhalation test detected 47 sites. Among these detected air leak sites, 34 sites were repaired by suturing or stapling. The postoperative air leak rate in the ICG group (20.8%) was significantly lower than the control group (37.0%, P = 0.011). ICG inhalation test was a favorable factor for reducing postoperative air leaks (OR: 0.40; 95%CI: 0.20–0.78; P = 0.008). Conclusions The ICG inhalation test facilitates the identification of air leak sites that may have been overlooked in the conventional submersion sealing test. This technique is useful to reduce postoperative air leaks for patients undergoing VATS. Trial registration Chinese Clinical Trial Registry: ChiCTR2300067603 on January 13rd 2023.
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spelling doaj-art-1df66359c9ea4e74aba50bebf266dc532025-08-20T02:32:05ZengBMCBMC Surgery1471-24822025-05-012511910.1186/s12893-025-02875-zEvaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective studyZhenfan Wang0Xue Tian1Zihan Wei2Hao Xu3Kunshan He4Chongwei Chi5Songjing Zhao6Ruiheng Jiang7Fan Yang8Yun Li9Jian Zhou10Department of Thoracic Surgery, Peking University People’s HospitalDepartment of Anaesthesia, Peking University People’s HospitalChina-Japan Friendship HospitalDepartment of Thoracic Surgery, Peking University People’s HospitalCAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of SciencesCAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of SciencesPeking University Health Science CenterDepartment of Thoracic Surgery, Beijing Aerospace General HospitalDepartment of Thoracic Surgery, Peking University People’s HospitalDepartment of Thoracic Surgery, Peking University People’s HospitalDepartment of Thoracic Surgery, Peking University People’s HospitalAbstract Background This study aimed to investigate the feasibility and clinical benefits of indocyanine green (ICG) inhalation for detecting air leak sites during video-assisted thoracoscopic surgery (VATS). Methods Between February 2023 and May 2023, a total of 288 patients underwent VATS were enrolled in this study. Among the population, 72 patients received ICG inhalation test following the traditional submersion sealing test. And 216 patients only underwent the submersion sealing test were matched using 1:3 propensity score matching analysis. The results of ICG inhalation test and the clinical outcomes were compared. Results In the ICG group, 48 air leak sites were detected in 25 patients (25/72, 34.7%). The conventional submersion sealing test identified 30 air leak sites, while the ICG inhalation test detected 47 sites. Among these detected air leak sites, 34 sites were repaired by suturing or stapling. The postoperative air leak rate in the ICG group (20.8%) was significantly lower than the control group (37.0%, P = 0.011). ICG inhalation test was a favorable factor for reducing postoperative air leaks (OR: 0.40; 95%CI: 0.20–0.78; P = 0.008). Conclusions The ICG inhalation test facilitates the identification of air leak sites that may have been overlooked in the conventional submersion sealing test. This technique is useful to reduce postoperative air leaks for patients undergoing VATS. Trial registration Chinese Clinical Trial Registry: ChiCTR2300067603 on January 13rd 2023.https://doi.org/10.1186/s12893-025-02875-zAir leaksVideo-assisted thoracoscopic surgeryIndocyanine greenInhalation
spellingShingle Zhenfan Wang
Xue Tian
Zihan Wei
Hao Xu
Kunshan He
Chongwei Chi
Songjing Zhao
Ruiheng Jiang
Fan Yang
Yun Li
Jian Zhou
Evaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective study
BMC Surgery
Air leaks
Video-assisted thoracoscopic surgery
Indocyanine green
Inhalation
title Evaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective study
title_full Evaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective study
title_fullStr Evaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective study
title_full_unstemmed Evaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective study
title_short Evaluation of indocyanine green inhalation to detect air leak sites during video-assisted thoracoscopic surgery: a prospective study
title_sort evaluation of indocyanine green inhalation to detect air leak sites during video assisted thoracoscopic surgery a prospective study
topic Air leaks
Video-assisted thoracoscopic surgery
Indocyanine green
Inhalation
url https://doi.org/10.1186/s12893-025-02875-z
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