关键词: 肺切除术；肺肿瘤；胸腔镜；体层摄影术, 螺旋计算机；吲哚菁绿；导航

Abstract: Objective　To investigate the feasibility and efficacy of three-dimensional CT（3D-CT） reconstruction combined with indocyanine green fluorescence（ICGF） in anatomical thoracoscopic segmentectomy.Methods　Twenty patients who underwent anatomical thoracoscopic segmentectomy in the Department of Thoracic Surgery，the First Affiliated Hospital of Bengbu Medical College between January and December 2017 were selected as study subjects，including 18 cases of primary lung cancer and 2 cases of metastatic lung cancer.The target segment of the pulmonary artery was evaluated preoperatively，and the virtual segment plane was reconstructed with 3D-CT.During the operation，when the target segment pulmonary artery and bronchus were separated，ICG （0.25 mg/kg） was intravenously injected.ICGF in the non-target segments（NTS） was observed，and the boundaries between target segments and NTS were marked with an electrical burn.Patient 's baseline characteristics，and the time of first appearance of fluorescence，the duration of ICGF and the duration of effective contrast and other surgical indicators were observed and recorded.Results　ICGF provided a clear mark delineating segments，and its fluorescence duration was sufficient to complete the labeling.Lung surface labeling and anatomical thoracoscopic segmentectomy were successfully completed in all 20 patients.The operation time was（186.0±41.5）min，and the blood loss was（30.0±17.8）ml.After the injection of ICG，the time of first appearance of fluorescence was（20.0±10.5） s，and the duration of fluorescence was（180.0±30.8） s；the duration of effective contrast was（70.0±11.6） s，which was sufficient for clinicians to perform labeling.The methods did not cause side effects in the patients.Conclusion　3D-CT reconstruction combined with ICGF allows for full preoperative evaluation and clearly shows the segmental boundary，thus providing a reliable technique for anatomical thoracoscopic segmentectomy.It is a safe and effective method worthy of further clinical use.

Key words: Pneumonectomy；Lung neoplasms；Laparoscopes；Tomography, spiral computed；Indocyanine green；Navigation