Advances in blocking pulmonary circulation to identify intersegmental plane during pulmonary segmentectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

DENG Yuanlin , TIE Hongtao ,  GE Mingjian

Department of Thoracic and Cardiac Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P. R. China;

Corresponding author：

GE Mingjian, Email: gemingjiancqyy@126.com

Keywords：

Pulmonary circulation; segmentectomy; intersegmental plane; review

DOI：

10.7507/1007-4848.202207012

Video：

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Accurate identification of intersegmental plane is one of the key steps of segmentectomy. Identification of intersegmental plane is usually based on differences in ventilation or circulation between the targeted segment and the reserved segment. In recent years, many methods of showing the intersegmental plane after blocking pulmonary circulation have emerged, and these methods have simplified segmentectomy and shortened the operation time. In this paper, we reviewed the related methods of blocking pulmonary circulation to identify the intersegmental plane.

Citation： DENG Yuanlin, TIE Hongtao, GE Mingjian. Advances in blocking pulmonary circulation to identify intersegmental plane during pulmonary segmentectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(10): 1390-1394. doi: 10.7507/1007-4848.202207012 Copy

1.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2.	Kidane B, Yasufuku K. Advances in image-guided thoracic surgery. Thorac Surg Clin, 2016, 26(2): 129-138.
3.	Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
4.	Fu HH, Feng Z, Li M, et al. The arterial-ligation-alone method for identifying the intersegmental plane during thoracoscopic anatomic segmentectomy. J Thorac Dis, 2020, 12(5): 2343-2351.
5.	Mun M, Nakao M, Matsuura Y, et al. Novel techniques for video-assisted thoracoscopic surgery segmentectomy. J Thorac Dis, 2018, 10(Suppl 14): S1671-S1676.
6.	陈亮, 葛明建. 肺段切除术中段间平面显示方法的研究进展. 中国肺癌杂志, 2020, 23(9): 818-823.
7.	Shi X, Ye J, Chen J, et al. Lung segmentectomy assisted by highly selective independent segmental ventilation: A series of three cases. J Cardiothorac Surg, 2021, 16(1): 87.
8.	Misaki N, Chang SS, Gotoh M, et al. A novel method for determining adjacent lung segments with infrared thoracoscopy. J Thorac Cardiovasc Surg, 2009, 138(3): 613-618.
9.	Speich R, Saesseli B, Hoffmann U, et al. Anaphylactoid reactions after indocyanine-green administration. Ann Intern Med, 1988, 109(4): 345-346.
10.	Ito A, Takao M, Shimamoto A, et al. Prolonged intravenous indocyanine green visualization by temporary pulmonary vein clamping: Real-time intraoperative fluorescence image guide for thoracoscopic anatomical segmentectomy. Eur J Cardiothorac Surg, 2017, 52(6): 1225-1226.
11.	Wada H, Yamamoto T, Morimoto J, et al. Near-infrared-guided pulmonary segmentectomy after endobronchial indocyanine green injection. Ann Thorac Surg, 2020, 109(2): 396-403.
12.	Sun Y, Zhang Q, Wang Z, et al. Is the near-infrared fluorescence imaging with intravenous indocyanine green method for identifying the intersegmental plane concordant with the modified inflation-deflation method in lung segmentectomy? Thorac Cancer, 2019, 10(10): 2013-2021.
13.	Sugimoto S, Oto T, Miyoshi K, et al. A novel technique for identification of the lung intersegmental plane using dye injection into the segmental pulmonary artery. J Thorac Cardiovasc Surg, 2011, 141(5): 1325-1327.
14.	Zhang Z, Liao Y, Ai B, et al. Methylene blue staining: A new technique for identifying intersegmental planes in anatomic segmentectomy. Ann Thorac Surg, 2015, 99(1): 238-242.
15.	Saito D, Matsumoto I, Waseda R, et al. A method to identify pulmonary intersegmental planes with intravenous vitamin B2 injection. Surg Today, 2021, 51(5): 836-843.
16.	Said HM. Water-soluble vitamins. World Rev Nutr Diet, 2015, 111: 30-37.
17.	Chu XP, Chen ZH, Lin SM, et al. Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules. Transl Lung Cancer Res, 2021, 10(4): 1711-1719.
18.	Pfitzner J, Peacock MJ, Harris RJ. Speed of collapse of the non-ventilated lung during single-lung ventilation for thoracoscopic surgery: The effect of transient increases in pleural pressure on the venting of gas from the non-ventilated lung. Anaesthesia, 2001, 56(10): 940-946.
19.	Iwata H, Shirahashi K, Mizuno Y, et al. Surgical technique of lung segmental resection with two intersegmental planes. Interact Cardiovasc Thorac Surg, 2013, 16(4): 423-425.
20.	Gao H, Liu C. Demarcation of arteriopulmonary segments: A novel and effective method for the identification of pulmonary segments. J Int Med Res, 2021, 49(5): 3000605211014383.
21.	Zhao Y, Xuan Y, Song J, et al. A novel technique for identification of the segments based on pulmonary artery plane combined with oxygen diffusing discrepancy. J Thorac Dis, 2019, 11(12): 5427-5432.
22.	Wang C, Cai L, Chen Q, et al. No-waiting segmentectomy: An optimized approach for segmentectomy. J Thorac Dis, 2021, 13(2): 784-788.
23.	Zhang M, Mao N, Wu QC, et al. A novel method for distinguishing the intersegmental plane: Pulmonary circulation single-blocking. J Thorac Dis, 2021, 13(1): 362-365.
24.	Chen L, Li Q, Chen X, et al. Emergence of transient intersegmental plane by pulmonary circulation single-blocking: Is it the true intersegmental plane? Interact Cardiovasc Thorac Surg, 2022, 34(2): 333-335.
25.	Sakamoto K, Kanzaki M, Mitsuboshi S, et al. A novel and simple method for identifying the lung intersegmental plane using thermography. Interact Cardiovasc Thorac Surg, 2016, 23(1): 171-173.
26.	Motoyama H, Chen F, Hijiya K, et al. Novel thermographic detection of regional malperfusion caused by a thrombosis during ex vivo lung perfusion. Interact Cardiovasc Thorac Surg, 2015, 20(2): 242-247.
27.	Li C, Liu Y. Detecting intersegmental plane in thoracoscopic segmentectomy using infrared thermography. Chin Med J (Engl), 2021, 135(1): 119-120.
28.	Wu W, He Z, Xu J, et al. Anatomical pulmonary sublobar resection based on subsegment. Ann Thorac Surg, 2021, 111(6): e447-e450.
29.	Wu WB, Xia Y, Pan XL, et al. Three-dimensional navigation-guided thoracoscopic combined subsegmentectomy for intersegmental pulmonary nodules. Thorac Cancer, 2019, 10(1): 41-46.
30.	Jones GD, Caso R, Choe G, et al. Intentional segmentectomy for clinical T1N0 non-small cell lung cancer: Survival differs by segment. Ann Thorac Surg, 2021, 111(3): 1028-1035.
31.	Wei S, Guo C, He J, et al. Effect of vein-first vs. artery-first surgical technique on circulating tumor cells and survival in patients with non-small cell lung cancer: A randomized clinical trial and registry-based propensity score matching analysis. JAMA Surg, 2019, 154(7): e190972.
32.	Aylwin JA. Avoidable vascular spread in resection for bronchial carcinoma. Thorax, 1951, 6(3): 250-267.
33.	Miller GE, Smeloff EA. Physiologic basis of preliminary venous ligation in the surgery of pulmonary neoplasms. Am J Surg, 1969, 118(6): 921-924.
34.	Zhang M, Wu QC, Ge MJ. The VVBA method for thoracoscopic right middle lobe segmentectomy. Gen Thorac Cardiovasc Surg, 2021, 69(1): 175-177.
35.	Zhang M, Chen L, Wu Q, et al. Functional preserving sublobectomy: A novel method for sublobectomy. Thorac Cardiovasc Surg, 2021. [Epub ahead of print].
36.	Zhang M, Mao N, Wu QC, et al. Vein or artery-first resection in right middle lobe segmentectomy: Which preserves more lung? Interact Cardiovasc Thorac Surg, 2021, 32(6): 993-995.

1. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
2. Kidane B, Yasufuku K. Advances in image-guided thoracic surgery. Thorac Surg Clin, 2016, 26(2): 129-138.
3. Saji H, Okada M, Tsuboi M, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): A multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet, 2022, 399(10335): 1607-1617.
4. Fu HH, Feng Z, Li M, et al. The arterial-ligation-alone method for identifying the intersegmental plane during thoracoscopic anatomic segmentectomy. J Thorac Dis, 2020, 12(5): 2343-2351.
5. Mun M, Nakao M, Matsuura Y, et al. Novel techniques for video-assisted thoracoscopic surgery segmentectomy. J Thorac Dis, 2018, 10(Suppl 14): S1671-S1676.
6. 陈亮, 葛明建. 肺段切除术中段间平面显示方法的研究进展. 中国肺癌杂志, 2020, 23(9): 818-823.
7. Shi X, Ye J, Chen J, et al. Lung segmentectomy assisted by highly selective independent segmental ventilation: A series of three cases. J Cardiothorac Surg, 2021, 16(1): 87.
8. Misaki N, Chang SS, Gotoh M, et al. A novel method for determining adjacent lung segments with infrared thoracoscopy. J Thorac Cardiovasc Surg, 2009, 138(3): 613-618.
9. Speich R, Saesseli B, Hoffmann U, et al. Anaphylactoid reactions after indocyanine-green administration. Ann Intern Med, 1988, 109(4): 345-346.
10. Ito A, Takao M, Shimamoto A, et al. Prolonged intravenous indocyanine green visualization by temporary pulmonary vein clamping: Real-time intraoperative fluorescence image guide for thoracoscopic anatomical segmentectomy. Eur J Cardiothorac Surg, 2017, 52(6): 1225-1226.
11. Wada H, Yamamoto T, Morimoto J, et al. Near-infrared-guided pulmonary segmentectomy after endobronchial indocyanine green injection. Ann Thorac Surg, 2020, 109(2): 396-403.
12. Sun Y, Zhang Q, Wang Z, et al. Is the near-infrared fluorescence imaging with intravenous indocyanine green method for identifying the intersegmental plane concordant with the modified inflation-deflation method in lung segmentectomy? Thorac Cancer, 2019, 10(10): 2013-2021.
13. Sugimoto S, Oto T, Miyoshi K, et al. A novel technique for identification of the lung intersegmental plane using dye injection into the segmental pulmonary artery. J Thorac Cardiovasc Surg, 2011, 141(5): 1325-1327.
14. Zhang Z, Liao Y, Ai B, et al. Methylene blue staining: A new technique for identifying intersegmental planes in anatomic segmentectomy. Ann Thorac Surg, 2015, 99(1): 238-242.
15. Saito D, Matsumoto I, Waseda R, et al. A method to identify pulmonary intersegmental planes with intravenous vitamin B2 injection. Surg Today, 2021, 51(5): 836-843.
16. Said HM. Water-soluble vitamins. World Rev Nutr Diet, 2015, 111: 30-37.
17. Chu XP, Chen ZH, Lin SM, et al. Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules. Transl Lung Cancer Res, 2021, 10(4): 1711-1719.
18. Pfitzner J, Peacock MJ, Harris RJ. Speed of collapse of the non-ventilated lung during single-lung ventilation for thoracoscopic surgery: The effect of transient increases in pleural pressure on the venting of gas from the non-ventilated lung. Anaesthesia, 2001, 56(10): 940-946.
19. Iwata H, Shirahashi K, Mizuno Y, et al. Surgical technique of lung segmental resection with two intersegmental planes. Interact Cardiovasc Thorac Surg, 2013, 16(4): 423-425.
20. Gao H, Liu C. Demarcation of arteriopulmonary segments: A novel and effective method for the identification of pulmonary segments. J Int Med Res, 2021, 49(5): 3000605211014383.
21. Zhao Y, Xuan Y, Song J, et al. A novel technique for identification of the segments based on pulmonary artery plane combined with oxygen diffusing discrepancy. J Thorac Dis, 2019, 11(12): 5427-5432.
22. Wang C, Cai L, Chen Q, et al. No-waiting segmentectomy: An optimized approach for segmentectomy. J Thorac Dis, 2021, 13(2): 784-788.
23. Zhang M, Mao N, Wu QC, et al. A novel method for distinguishing the intersegmental plane: Pulmonary circulation single-blocking. J Thorac Dis, 2021, 13(1): 362-365.
24. Chen L, Li Q, Chen X, et al. Emergence of transient intersegmental plane by pulmonary circulation single-blocking: Is it the true intersegmental plane? Interact Cardiovasc Thorac Surg, 2022, 34(2): 333-335.
25. Sakamoto K, Kanzaki M, Mitsuboshi S, et al. A novel and simple method for identifying the lung intersegmental plane using thermography. Interact Cardiovasc Thorac Surg, 2016, 23(1): 171-173.
26. Motoyama H, Chen F, Hijiya K, et al. Novel thermographic detection of regional malperfusion caused by a thrombosis during ex vivo lung perfusion. Interact Cardiovasc Thorac Surg, 2015, 20(2): 242-247.
27. Li C, Liu Y. Detecting intersegmental plane in thoracoscopic segmentectomy using infrared thermography. Chin Med J (Engl), 2021, 135(1): 119-120.
28. Wu W, He Z, Xu J, et al. Anatomical pulmonary sublobar resection based on subsegment. Ann Thorac Surg, 2021, 111(6): e447-e450.
29. Wu WB, Xia Y, Pan XL, et al. Three-dimensional navigation-guided thoracoscopic combined subsegmentectomy for intersegmental pulmonary nodules. Thorac Cancer, 2019, 10(1): 41-46.
30. Jones GD, Caso R, Choe G, et al. Intentional segmentectomy for clinical T1N0 non-small cell lung cancer: Survival differs by segment. Ann Thorac Surg, 2021, 111(3): 1028-1035.
31. Wei S, Guo C, He J, et al. Effect of vein-first vs. artery-first surgical technique on circulating tumor cells and survival in patients with non-small cell lung cancer: A randomized clinical trial and registry-based propensity score matching analysis. JAMA Surg, 2019, 154(7): e190972.
32. Aylwin JA. Avoidable vascular spread in resection for bronchial carcinoma. Thorax, 1951, 6(3): 250-267.
33. Miller GE, Smeloff EA. Physiologic basis of preliminary venous ligation in the surgery of pulmonary neoplasms. Am J Surg, 1969, 118(6): 921-924.
34. Zhang M, Wu QC, Ge MJ. The VVBA method for thoracoscopic right middle lobe segmentectomy. Gen Thorac Cardiovasc Surg, 2021, 69(1): 175-177.
35. Zhang M, Chen L, Wu Q, et al. Functional preserving sublobectomy: A novel method for sublobectomy. Thorac Cardiovasc Surg, 2021. [Epub ahead of print].
36. Zhang M, Mao N, Wu QC, et al. Vein or artery-first resection in right middle lobe segmentectomy: Which preserves more lung? Interact Cardiovasc Thorac Surg, 2021, 32(6): 993-995.

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