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ENDOBRONCHIAL ULTRASOUND (EBUS) SONOGRAPHIC FEATURES OF MEDIASTINAL LYMPH NODES ASSOCIATED WITH MALIGNANCY AMONG PATIENTS WHO UNDERWENT EBUS‐GUIDED TRANSBRONCHIAL NEEDLE ASPIRATION (TBNA) BIOPSY

consecutive patients were prospectively registered in this study. ICG was intravenously injected before and after harvesting the pedunculated pericardial fat tissue flap. The ICG fluorescence intensity of the distal and proximal sides of the flap was macroscopically scored to evaluate the quality of reliable reinforcement. Results: The median duration of harvesting time was 9.7 minutes. ICG fluorescence showed ischemia on the distal side of the fat pad in 2 out of 9 cases. These 2 patients showed a decreased density of green fluorescence in the distal part 1 minute after ICG administration; however, the blood stream could be observed even in the distal part of the flaps. Neither bronchial fistula nor severe complications occurred during postoperative hospitalization. One patient developed empyema without bronchial fistula on the 30th post-operative day (POD) and was treated with antibiotics and chest tube drainage. Another patient developed slight pneumothorax on POD 23; however, no specific therapy was required. A distinct covering tissue could be observed postoperatively in all the patients on computed tomography performed 1 month after the surgery. Conclusions: This pilot study confirmed the significant quality of vascularization of pedunculated pericardial fat pad and usefulness of ICG fluorescence to evaluate its blood supply.