Naoya Yokota1, Tetsuhiko Go2, Atsushi Fujiwara2, Ayumu Kato2, Yasuhiro Otsuki2, Hiroyasu Yokomise2. 1. Department of General Thoracic Surgery, Breast and Endocrinological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan. Electronic address: naoe@med.kagawa-u.ac.jp. 2. Department of General Thoracic Surgery, Breast and Endocrinological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Abstract
BACKGROUND: Efficient methods for the detection and repair of pleural defects are crucial for preventing postoperative air leaks; however, there are few studies on sealing test methods. We developed a new sealing test method that involves the administration of aerosolized indocyanine green into the airway. This experimental study aimed to confirm whether this method could identify alveolar-pleural fistulas. METHODS: Thoracotomy was performed on 6 beagles under general anesthesia. Pleural defects accompanying air leaks were created in the cranial and caudal lobes. Using a pediatric jet nebulizer kit, 5 mL of 2.5 mg/mL aerosolized indocyanine green solution was administered to the entire lung through a catheter placed in the trachea. Pleural defects were observed using a near-infrared light scope, and the time until confirmation of the defect sites was measured. RESULTS: Of the 25 pleural defect sites created, 24 could be identified under a near-infrared light camera. The average time required for confirming the site of pleural defect was 13.8 seconds (95% confidence interval, 7.32-16.8 seconds). CONCLUSIONS: By administering aerosolized indocyanine green into the airway, the site of alveolar-pleural fistula could be identified with a near-infrared light camera in a canine pleural defect model. This method could be a valid sealing test and is suitable for video-assisted thoracic surgery, as it allows for observation of the lung in a collapsed state with a long observation time. Further studies are needed to determine the optimal dose of indocyanine green and to confirm the method's applicability and efficacy in humans.
BACKGROUND: Efficient methods for the detection and repair of pleural defects are crucial for preventing postoperative air leaks; however, there are few studies on sealing test methods. We developed a new sealing test method that involves the administration of aerosolized indocyanine green into the airway. This experimental study aimed to confirm whether this method could identify alveolar-pleural fistulas. METHODS: Thoracotomy was performed on 6 beagles under general anesthesia. Pleural defects accompanying air leaks were created in the cranial and caudal lobes. Using a pediatric jet nebulizer kit, 5 mL of 2.5 mg/mL aerosolized indocyanine green solution was administered to the entire lung through a catheter placed in the trachea. Pleural defects were observed using a near-infrared light scope, and the time until confirmation of the defect sites was measured. RESULTS: Of the 25 pleural defect sites created, 24 could be identified under a near-infrared light camera. The average time required for confirming the site of pleural defect was 13.8 seconds (95% confidence interval, 7.32-16.8 seconds). CONCLUSIONS: By administering aerosolized indocyanine green into the airway, the site of alveolar-pleural fistula could be identified with a near-infrared light camera in a caninepleural defect model. This method could be a valid sealing test and is suitable for video-assisted thoracic surgery, as it allows for observation of the lung in a collapsed state with a long observation time. Further studies are needed to determine the optimal dose of indocyanine green and to confirm the method's applicability and efficacy in humans.