A feasible technique for distinguishing the intersegmental plane by transbronchial injection of iron sucroseCentral MessagePerspective

Objectives: Pulmonary segmentectomy should be the standard surgical procedure for patients in certain clinical scenarios. However, detecting the intersegmental planes both on the pleural surface and within the lung parenchyma remains a challenge. We developed an intraoperative novel method for disti...

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Main Authors: Chengqiang Li, MD, PhD, Xianfei Zhang, MD, PhD, Xijia Feng, MD, PhD, Dingpei Han, MD, PhD, Jie Xiang, MD, PhD, Hecheng Li, MD, PhD
Format: Article
Language:English
Published: Elsevier 2023-04-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250723000044
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author Chengqiang Li, MD, PhD
Xianfei Zhang, MD, PhD
Xijia Feng, MD, PhD
Dingpei Han, MD, PhD
Jie Xiang, MD, PhD
Hecheng Li, MD, PhD
author_facet Chengqiang Li, MD, PhD
Xianfei Zhang, MD, PhD
Xijia Feng, MD, PhD
Dingpei Han, MD, PhD
Jie Xiang, MD, PhD
Hecheng Li, MD, PhD
author_sort Chengqiang Li, MD, PhD
collection DOAJ
description Objectives: Pulmonary segmentectomy should be the standard surgical procedure for patients in certain clinical scenarios. However, detecting the intersegmental planes both on the pleural surface and within the lung parenchyma remains a challenge. We developed an intraoperative novel method for distinguishing intersegmental planes of the lung via transbronchial injection of iron sucrose (ClinicalTrials.gov number, NCT03516500). Methods: We first performed a bronchial injection of iron sucrose to identify the intersegmental plane of the porcine lung. Then, we conducted a prospective study to evaluate the safety and feasibility of the technique in 20 patients who underwent anatomic segmentectomy. Iron sucrose was injected into the bronchus of target pulmonary segments, and the intersegmental planes were divided with electrocautery or stapler. Results: The median injection of iron sucrose was 90 mL (range, 70-120 mL), and the median time from injection of iron sucrose to demarcation of intersegmental plane was 8 minutes (range, 3-25 minutes). Qualified identification of the intersegmental plane was observed in 17 cases (85%). The intersegmental plane could not be recognized in 3 cases. All patients experienced no complications related to iron sucrose injection or complications of Clavien–Dindo grade 3 or more. Conclusions: Transbronchial injection of iron sucrose is a simple, safe, and feasible approach to identify the intersegmental plane (NCT03516500).
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publishDate 2023-04-01
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series JTCVS Techniques
spelling doaj-art-21faf63dc82e47d5b8d8b6d3ef59e8842025-08-20T03:36:42ZengElsevierJTCVS Techniques2666-25072023-04-011813714210.1016/j.xjtc.2022.12.007A feasible technique for distinguishing the intersegmental plane by transbronchial injection of iron sucroseCentral MessagePerspectiveChengqiang Li, MD, PhD0Xianfei Zhang, MD, PhD1Xijia Feng, MD, PhD2Dingpei Han, MD, PhD3Jie Xiang, MD, PhD4Hecheng Li, MD, PhD5Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaDepartment of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaAddress for reprints: Hecheng Li, MD, PhD, Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin 2nd Rd, Shanghai, China 200025.; Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, ChinaObjectives: Pulmonary segmentectomy should be the standard surgical procedure for patients in certain clinical scenarios. However, detecting the intersegmental planes both on the pleural surface and within the lung parenchyma remains a challenge. We developed an intraoperative novel method for distinguishing intersegmental planes of the lung via transbronchial injection of iron sucrose (ClinicalTrials.gov number, NCT03516500). Methods: We first performed a bronchial injection of iron sucrose to identify the intersegmental plane of the porcine lung. Then, we conducted a prospective study to evaluate the safety and feasibility of the technique in 20 patients who underwent anatomic segmentectomy. Iron sucrose was injected into the bronchus of target pulmonary segments, and the intersegmental planes were divided with electrocautery or stapler. Results: The median injection of iron sucrose was 90 mL (range, 70-120 mL), and the median time from injection of iron sucrose to demarcation of intersegmental plane was 8 minutes (range, 3-25 minutes). Qualified identification of the intersegmental plane was observed in 17 cases (85%). The intersegmental plane could not be recognized in 3 cases. All patients experienced no complications related to iron sucrose injection or complications of Clavien–Dindo grade 3 or more. Conclusions: Transbronchial injection of iron sucrose is a simple, safe, and feasible approach to identify the intersegmental plane (NCT03516500).http://www.sciencedirect.com/science/article/pii/S2666250723000044intersegmental planeiron sucrosesegmentectomy
spellingShingle Chengqiang Li, MD, PhD
Xianfei Zhang, MD, PhD
Xijia Feng, MD, PhD
Dingpei Han, MD, PhD
Jie Xiang, MD, PhD
Hecheng Li, MD, PhD
A feasible technique for distinguishing the intersegmental plane by transbronchial injection of iron sucroseCentral MessagePerspective
JTCVS Techniques
intersegmental plane
iron sucrose
segmentectomy
title A feasible technique for distinguishing the intersegmental plane by transbronchial injection of iron sucroseCentral MessagePerspective
title_full A feasible technique for distinguishing the intersegmental plane by transbronchial injection of iron sucroseCentral MessagePerspective
title_fullStr A feasible technique for distinguishing the intersegmental plane by transbronchial injection of iron sucroseCentral MessagePerspective
title_full_unstemmed A feasible technique for distinguishing the intersegmental plane by transbronchial injection of iron sucroseCentral MessagePerspective
title_short A feasible technique for distinguishing the intersegmental plane by transbronchial injection of iron sucroseCentral MessagePerspective
title_sort feasible technique for distinguishing the intersegmental plane by transbronchial injection of iron sucrosecentral messageperspective
topic intersegmental plane
iron sucrose
segmentectomy
url http://www.sciencedirect.com/science/article/pii/S2666250723000044
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