The Wide Range of Uses of Indocyanine Green in Thoracic Surgery: State-of-the-art

Abstract Background: Thoracic surgery is a constantly evolving field that require innovative solutions. Invisible near-infrared fluorescence imaging with indocyanine green is an intraoperative technology that could be help for surgeons. Indocyanine green is a nontoxic dye with low rate of adverse reaction. Indocyanine green binds with plasma proteins and lipoprotein that allow a deep tissue penetration, and also the amphiphilic proprieties allow indocyanine green to migrate within lymphatics. Methods: We selected forty-nine previous studies from the literature searching terms “lung cancer”, “indocyanine green”, “thoracic surgery”, “fluorescent images”. The topics of the paper were: sentinel lymph node mapping, pulmonary nodes identification, intersegmental plane identification, and other application (pulmonary bullous lesions, bronchopleural fistula, bronchoplasty, pulmonary sequestration, chyle leak, hyperidrosis). Results: In the different applications indocyanine green showed a high identification rate, overall accuracy, sensibility, and specificity. Conclusions: This review describes the advantages and current applications in thoracic surgery of intraoperative near-infrared fluorescence imaging using indocyanine green.