Delineation of Intersegmental Plane: Application of Blood Flow Blocking Method in Pulmonary Segmentectomy

Abstract Background: The Modified Inflation-Deflation Method (MIDM) is widely used in China in pulmonary segmentectomies. We optimized the procedure, which was named as Blood Flow Blocking Method (BFBM), also known as "No-Waiting Segmentectomy”. This method has produced commendable clinical outcomes in segmentectomies. The aim of this research is to confirm whether the intersegmental planes formed by MIDM and BFBM techniques during segmentectomies have high degree of concordance. Methods: We utilized the Open Sequential Test design in our study. Using both MIDM and BFBM techniques, intersegmental planes were created in the same patient, one after the other. The degree of alignment between the planes formed by the two techniques was assessed by two experienced chief surgeons. Based on the results obtained in each case, a test line was plotted until it intersected the effective or ineffective line. Results: In every case studied, the intersegmental planes created by the MIDM and BFBM displayed high congruity. The test line crossed the effective line during the 12th case. When comparing the time taken to form the intersegmental plane using either MIDM or BFBM technique, no significant difference was observed. However, the application of the BFBM technique resulted in an average time savings of 13.8 minutes. Conclusions: In segmentectomies, the intersegmental planes formed by MIDM and BFBM techniques exhibit high concordance. However, given that BFBM affords a time-saving advantage, we propose that BFBM could potentially replace MIDM in performing lung segmentectomies.