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J Thorac Cardiovasc Surg 2007;134:1498-1501
© 2007 The American Association for Thoracic Surgery

General Thoracic Surgery

Clinical application of infrared thoracoscopy to detect bullous or emphysematous lesions of the lung

Masashi Gotoh, MD, Yasumichi Yamamoto, MD, Hitoshi Igai, MD, Sungsoo Chang, MD, Chenglong Huang, MD, Hiroyasu Yokomise, MD*

Second Department of Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.

Received for publication May 24, 2007; accepted for publication July 5, 2007.

* Address for reprints: Hiroyasu Yokomise, MD, Second Department of Surgery, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki, Kita-gun, Kagawa 761-0793 Japan. (Email: yokomise{at}kms.ac.jp).

Objective: We have previously reported that infrared thoracoscopy was useful in detecting emphysematous lesions in a canine model of lung emphysema. We applied infrared thoracoscopy to determine the feasibility and efficacy of planning bullectomy for patients with spontaneous pneumothorax.

Methods: A total of 8 patients with spontaneous pneumothorax were included in the study. No procedure-related complications were observed. Infrared thoracoscopy with a single injection of indocyanine green (3.0 mg/kg) was used to detect bullous lesions of the lung during surgical intervention. Partial lung resections of the bullous lesions were performed after image analysis based on color density data obtained by means of infrared thoracoscopy.

Results: Bullous or emphysematous lesions of the lung were demonstrated in white, whereas normal lung tissue was imaged in blue, under infrared thoracoscopy. We were able to detect small bullous lesions with infrared thoracoscopy because of its clearer visualization compared with thoracoscopy. Quantitative color-density analysis revealed a marked decrease of indocyanine green intensity, which reflected decreased blood flow of bullous lesions. All resected specimens were confirmed as bullous lesions based on microscopic examinations.

Conclusion: Infrared thoracoscopy–guided lung resection is a safe and useful procedure in detecting small bullous lesions.

Abbreviations and Acronyms CDR = color density ratio; ICG = indocyanine green; IRT = infrared thoracoscopy; VATS = video-assisted thoracoscopic surgery




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N. Misaki, S. S. Chang, M. Gotoh, Y. Yamamoto, K. Satoh, and H. Yokomise
A novel method for determining adjacent lung segments with infrared thoracoscopy
J. Thorac. Cardiovasc. Surg., September 1, 2009; 138(3): 613 - 618.
[Abstract] [Full Text] [PDF]


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