Evidence map›Paper›PMID 39974551›Full record

ArticleSurgical case reports2025

Successful Right Upper Lung Segmentectomy after Esophagectomy: Utilization of 4K 3-Dimensional Endoscopy and Near-Infrared Fluorescence in High-Risk Surgery.

Masaya Otabe, Sayaka Yamada, Atsushi Kagimoto, Takeshi Mimura

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Article in Surgical case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Masaya OtabeDepartment of General Thoracic Surgery, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan.
Sayaka YamadaThe Clinical Training Center, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan.
Atsushi KagimotoDepartment of General Thoracic Surgery, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan.
Takeshi MimuraDepartment of General Thoracic Surgery, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLung resection after open esophagectomy poses significant technical challenges, particularly when the reconstructed gastrointestinal tract is on the same side as the lung lesion. The advent of 4K 3-dimensional (3D) endoscopic systems with near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has improved the precision of thoracic surgeries. We present a case of successful right upper lung segmentectomy for primary lung cancer after open esophagectomy, utilizing a 4K 3D endoscopic system and NIR imaging. CASE PRESENTATION: An 85-year-old female with a history of open esophagectomy for esophageal cancer 19 years earlier and comorbidities, including aplastic anemia and diabetes mellitus, was referred for the evaluation of a growing lesion in the right upper lung. Computed tomography (CT) revealed a 43-mm tumor and the gastric tube, reconstructed during the prior esophagectomy, located in the right thoracic cavity. A CT-guided biopsy confirmed lung adenocarcinoma (cT2bN0M0, Stage IIA). Surgical challenges included severe adhesions from the previous thoracotomy and thrombocytopenia (platelet count: 20000) due to aplastic anemia. A thoracoscopic segmentectomy of the anterior segment of the right upper lobe was performed using a 4K 3D endoscopic system (TIPCAM1 Rubina; Karl Storz, Tuttlingen, Germany). Adhesions were meticulously dissected, and intraoperative platelet transfusions were administered. NIR imaging with ICG identified the intersegmental plane and confirmed blood flow to the gastric tube, preventing ischemic complications. The lung segmentectomy was completed using staplers, preserving the right gastroepiploic artery. Histopathology revealed acinar adenocarcinoma (pT3N0M0, Stage IIB). The patient resumed oral intake on postoperative Day 1 and was discharged on Day 13 without complications. No recurrence was noted during the follow-up.

conclusionsThis case demonstrates the effective use of 4K 3D endoscopic systems and NIR imaging with ICG in complex lung resections following open esophagectomy. These technologies facilitate precise dissection and blood flow assessment, which are crucial for preserving reconstructed structures and enhancing surgical safety.

Indexed as

4K 3-dimensional endoscopic systemesophagectomylung segmentectomy

Identifiers

PMID39974551
PMCPMC11836011

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