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Number of dye marks required in virtual-assisted lung mapping

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Abstract

Objectives

Virtual-assisted lung mapping is a preoperative bronchoscopic multi-spot dye-marking technique used in sublobar lung resection for hardly palpable lung nodules. However, the number of marks required per nodule remains unknown. Therefore, we examined the correlation between the number of intraoperative visible marks and the successful resection rate.

Methods

We retrospectively examined 210 consecutive patients with 256 lesions who underwent virtual-assisted lung mapping during January 2014–December 2020 at our hospital. When a nodule was not resected at the initial attempt, or when a nodule was very close to the cut margin in the resected specimen and required additional resection, we categorized it as unsuccessful resection. We divided 256 lesions into successful and unsuccessful groups and compared the numbers of intraoperative visible marks between the two groups.

Results

Of 797 attempted marks, 738 (92.4%) were visible during the surgery. Fourteen (5.4%) of 256 lesions were determined to be unsuccessful according to the study criteria. There was a remarkable difference in the average numbers of intraoperative visible marks between both groups (3 [interquartile range: 2–4] vs. 2 [interquartile range: 1–2.8]; p < 0.01). Multivariable logistic analysis revealed a significant difference in the number of intraoperative visible marks (odds ratio: 0.28, 95% confidence interval: 0.14–0.57; p < 0.001) between both groups.

Conclusions

Successful sublobar lung resection requires three or more intraoperative visible marks established using virtual-assisted lung mapping per lung nodule.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

CT:

Computed tomography

ENB:

Electromagnetic navigation bronchoscopy

VAL-MAP:

Virtual-assisted lung mapping

VATS:

Video-assisted thoracic surgery

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Acknowledgements

The authors would like to thank Enago (https://www.enago.jp) for the English language review.

Funding

This study did not receive any funding.

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Authors and Affiliations

  1. Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan

    Masaaki Nagano, Masaaki Sato, Masahiro Yanagiya, Keita Nakao, Chihiro Konoeda, Kentaro Kitano & Jun Nakajima

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  1. Masaaki Nagano
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  2. Masaaki Sato
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  3. Masahiro Yanagiya
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  4. Keita Nakao
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  5. Chihiro Konoeda
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  6. Kentaro Kitano
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  7. Jun Nakajima
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Correspondence to Masaaki Nagano.

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Nagano, M., Sato, M., Yanagiya, M. et al. Number of dye marks required in virtual-assisted lung mapping. Gen Thorac Cardiovasc Surg 71, 313–320 (2023). https://doi.org/10.1007/s11748-022-01896-2

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  • DOI: https://doi.org/10.1007/s11748-022-01896-2

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