Usefulness of near-infrared fluorescence for identifying the segmental bronchus in minimally invasive segmentectomy.

Minimally invasive anatomical sublobar resections have gained relevance in recent years mainly due to advances in imaging techniques, screening programs and the increase in second neoplasms. Accurate identification of the segmental or subsegmental bronchus is vital to guarantee optimal results in segmentectomies and subsegmentectomies. Given the complexity and the possibility of anatomical variations, several authors have published different methods to identify the target bronchus. However, these methods have certain limitations. This article describes a new rapid and effective technique, with a low risk of complications and without additional cost, for the identification of segmental bronchi in minimally invasive segmentectomies.

"Long-term follow-up of liver transplantation in incidental intrahepatic cholangiocarcinoma and mixed hepatocellular-cholangiocarcinoma".

INTRODUCTION: The standard treatment for intrahepatic cholangiocarcinoma (iCCA) and mixed hepatocellular-cholangiocarcinoma (HCC-CC) is surgical resection, nevertheless, recent studies show adequate survival rates in selected patients with iCCA or HCC-CC undergoing liver transplantation (LT). METHODS: A retrospective cohort study was design including all patients undergoing LT at our center between January, 2006 and December, 2019 with incidentally diagnosed iCCA or HCC-CC after pathological examination of the explanted liver (n = 13). RESULTS: There were no iCCA or HCC-CC recurrences during the follow-up, and hence, there were no tumor related deaths. Global and disease-free survival were the same. The 1, 3 and 5-years patient survival were 92.3%, 76.9% and 76.9%, respectively. Survival rates in the "early-stage tumor group" at 1, 3 and 5 years were 100%, 83.3% and 83.3%, respectively, with no significant differences as compared to the "advanced-stage tumors group". No statistically significant differences in terms of 5-year survival were found when comparing tumor histology (85.7% for iCCA and 66.7% for HCC-CC). CONCLUSIONS: These results suggest that LT could be an option in patients with chronic liver disease who develop an iCCA or HCC-CC, even in highly selected advanced tumors, but we must be cautious when analyzing these results because of the small sample size of the series and its retrospective nature.