ArticleLung2026
Utility and Safety of a Novel Preoperative Marking via Ultrathin Bronchoscopy in Thoracic Surgery.
Article in Lung, 2026. 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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12 authors.
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Abstract
purposeVirtual-assisted lung mapping (VAL-MAP) is a safe and useful procedure for identifying suitable lines for sublobar lung resections. Nonetheless, the current VAL-MAP technique using a thin bronchoscope limits access to peripheral lung regions, including the upper lobes or the S6 region.
methodsTo overcome this limitation, we developed a new technique utilizing an ultrathin bronchoscope (UTB), termed 'UTB VAL-MAP', enabling precise dye marking of the visceral pleura which is difficult to access with a thin bronchoscope. We retrospectively evaluated the efficacy and safety of UTB VAL-MAP with those of conventional VAL-MAP at our institution.
resultsOverall, 178 preoperative markings (75 patients) were included: 74 markings in 35 patients in the UTB VAL-MAP group and 104 markings in 40 patients in the conventional VAL-MAP group. The overall detection rate in the UTB VAL-MAP group was significantly higher than that in the conventional VAL-MAP group [97.3% (72/74) vs. 84.6% (88/104); P = 0.005]. Furthermore, the marking success rate using indigo carmine in the UTB VAL-MAP group was higher for lesions located in the upper lobe and S6 region than that in the conventional VAL-MAP group (P < 0.001). In multivariate generalized estimating equations models, UTB use (odds ratio = 7.390, P = 0.015) was significantly associated with overall detection rate. No severe procedure-related complications occurred in either group.
conclusionUTB VAL-MAP appears useful for increasing the rate of successful visceral pleura marking, particularly in the upper lobes or S6 areas, which the conventional VAL-MAP technique has difficulty reaching, without increasing complications.
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