WCLC 2025 - Posters & ePosters-EP.07.28 Real-Time Image-Guided Indocyanine Green Fluorescencedual-Visualization Technique Forthoracoscopic Segmentectomy

EP.07.28 Real-Time Image-Guided Indocyanine Green Fluorescencedual-Visualization Technique Forthoracoscopic Segmentectomy

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This presentation from the Department of Thoracic Surgery at Nanjing Chest Hospital discusses advancements in sublobar resection for early-stage non-small cell lung cancer (NSCLC), focusing on a novel dual-visualization technique using indocyanine green fluorescence (ICGF) during thoracoscopic segmentectomy. Historically, lobectomy has been the standard surgical treatment for stage IA lung cancer, supported by the LCSG821 trial which showed higher recurrence with sublobar resections. However, limitations of that study and recent trials such as JCOG0802 and GALGB140503 have indicated that segmentectomy can achieve comparable or even superior overall survival and relapse-free survival compared to lobectomy for small (≤2cm), peripheral tumors without lymph node involvement.<br /><br />A key challenge in sublobar resection is ensuring sufficient surgical margins (≥2 cm or tumor-to-margin ratio ≥1.0) while maximally preserving lung function. To address this, accurate intraoperative localization of pulmonary nodules and clear identification of intersegmental planes (ISPs) are crucial. The Nanjing Chest Hospital approach integrates mobile CT for precise nodule localization with fluorescence imaging-guided anatomical segmentectomy.<br /><br />The ICG dual-visualization technique involves systemic injection of indocyanine green to simultaneously highlight pulmonary nodules and define ISPs in real time during surgery. This enables the surgeon to confirm tumor location and ensure a reliable surgical margin while preserving lung tissue. The technique offers a painless, quick localization with high success and low complication rates, thus supporting oncological principles and functional preservation.<br /><br />In summary, sublobar segmentectomy guided by ICG fluorescence dual-visualization represents a promising advance potentially challenging lobectomy as the standard for small peripheral lung cancers. It facilitates precise, individualized resections with verified margins, improving safety and outcomes in thoracoscopic lung cancer surgery.

Asset Subtitle

Feng Shao

Meta Tag

Speaker Feng Shao

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

sublobar resection

non-small cell lung cancer

NSCLC

indocyanine green fluorescence

ICGF

thoracoscopic segmentectomy

lobectomy

pulmonary nodule localization

intersegmental plane identification

lung cancer surgery