インドシアニングリーン併用赤外光観察システムにより胸腔鏡下分画肺切除を行った肺葉内肺分画症の1例

A case of intralobar pulmonary sequestration (IPS) of the right lung treated with complete thoracoscopic surgery (CTS) using infrared thoracoscopy (IRT) with indocyanine green (ICG)

◆要旨：稀な疾患である肺分画症の外科治療の基本は病巣の切除と異常動脈の切離であるが，肺葉内肺分画症では分画肺と正常肺との境界が炎症性変化の影響で不明瞭となり分画肺の領域が同定できない症例がある．今回，赤外光胸腔鏡によるインドシアニングリーン蛍光ナビゲーションで正常肺と分画肺の領域を同定し，胸腔鏡下分画肺切除術を施行した．インドシアニングリーン蛍光ナビゲーションを用いた完全胸腔鏡下肺内分画症の手術は本邦初の報告となる．

　Pulmonary sequestration is a relatively rare congenital anomaly and definitive treatment involves resection of the affected lung segment and transection of aberrant artery.　However, in the intralobar type, which has the same pleura as the remaining lung and has infectious changes, it is often difficult to determine the line of the involved lung parenchyma. In our case, we succeeded in visualizing the line of the affected lung segment using IRT with ICG and performed resection of the affected lung. We reported the first case of IPS treated with CTS using IRT with ICG.