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Journal of Cardiothoracic Surgery

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Open Access 01-12-2021 | Computed Tomography | Case report

VATS right posterior segmentectomy with anomalous bronchi and pulmonary vessels: a case report and literature review

Authors: Jianbin Zhang, Yilv Zhu, Hongwei Li, Caihua Yu, Weiwei Min

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

Anatomic variation may increase the difficulty and risk of anatomic segmentectomy. The preoperative three-dimensional computed tomography bronchography and angiography (3D-CTBA) can provide a detailed model of the segmental structure, and contribute to precise and safe segmentectomy.

Case presentation

This is a case of anomalous bronchi and pulmonary vessels in the right upper posterior segment (RS²). Under the guidance of 3D-CTBA, anatomic RS² segmentectomy was performed accurately and safely. The postoperative condition was uneventful.

Conclusions

This rare case highlights the importance of 3D-CTBA to guild accurate segmentectomy with anatomic variation.

Nakazawa S, Shimizu K, Mogi A, Kuwano H. VATS segmentectomy: past, present, and future. Gen Thorac Cardiovasc Surg. 2018;66(2):81–90. https://doi.org/10.1007/s11748-017-0878-6.CrossRefPubMed

Sato Y, Fujimoto D, Morimoto T, Uehara K, Nagata K, Sakanoue I, Hamakawa H, Takahashi Y, Imai Y, Tomii K. Natural history and clinical characteristics of multiple pulmonary nodules with ground glass opacity. Respirology. 2017;22(8):1615–21. https://doi.org/10.1111/resp.13089.CrossRefPubMed

Aragaki M, Iimura Y, Yoshida Y, Hasegawa N. Anomalous V(2) of the left pulmonary vein detected using three-dimensional computed tomography in a patient with lung cancer: a case report. Int J Surg Case Rep. 2017;37:208–10. https://doi.org/10.1016/j.ijscr.2017.06.046.CrossRefPubMedPubMedCentral

Ohtaka K, Iwashiro N, Watanabe K, Mizota T, Takahashi R, Suzuoki M, Komuro K, Ohara M, Kaga K, Matsui Y. A left lung abscess with a displaced subsegmental bronchus and anomalous pulmonary artery and vein: a case report. Surg Case Rep. 2019;5(1):66. https://doi.org/10.1186/s40792-019-0627-4.CrossRefPubMedPubMedCentral

Qi W, Yang F, Liu H, Sun Y. Thoracoscopic right apical segmentectomy for lung cancer with tracheal bronchus and variable pulmonary vein: a case report and literature review. J Int Med Res. 2020;48(8):300060520947935. https://doi.org/10.1177/0300060520947935.CrossRefPubMed

Chang SS, Okamoto T, Tokunaga Y, Nakano T. Intraoperative computed tomography navigation during thoracoscopic Segmentectomy for small-sized lung tumors. Semin Thorac Cardiovasc Surg. 2018;30(1):96–101. https://doi.org/10.1053/j.semtcvs.2017.08.005.CrossRefPubMed

Tane S, Nishio W, Nishioka Y, Tanaka H, Ogawa H, Kitamura Y, Takenaka D, Yoshimura M. Evaluation of the residual lung function after thoracoscopic Segmentectomy compared with lobectomy. Ann Thorac Surg. 2019;108(5):1543–50. https://doi.org/10.1016/j.athoracsur.2019.05.052.CrossRefPubMed

Wu WB, Xu XF, Wen W, Xu J, Zhu Q, Chen L. Thoracoscopic pulmonary sub-Subsegmentectomy based on three-dimensional images. Ann Thorac Surg. 2016;102(5):e389–91. https://doi.org/10.1016/j.athoracsur.2016.04.048.CrossRefPubMed

Sato M, Murayama T, Nakajima J. Thoracoscopic stapler-based "bidirectional" segmentectomy for posterior basal segment (S10) and its variants. J Thorac Dis. 2018;10(Suppl 10):S1179–86. https://doi.org/10.21037/jtd.2018.01.31.CrossRefPubMedPubMedCentral

10.

Shimizu K, Nagashima T, Yajima T, Ohtaki Y, Obayashi K, Nakazawa S, Kosaka T, Mogi A, Kuwano H. Thoracoscopic medial-basal segment Segmentectomy. Ann Thorac Surg. 2017;104(5):e403–6. https://doi.org/10.1016/j.athoracsur.2017.07.006.CrossRefPubMed

11.

Fukuhara K, Akashi A, Nakane S, Tomita E. Preoperative assessment of the pulmonary artery by three-dimensional computed tomography before video-assisted thoracic surgery lobectomy. Eur J Cardiothorac Surg. 2008;34(4):875–7. https://doi.org/10.1016/j.ejcts.2008.07.014.CrossRefPubMed

12.

Shimizu K, Nakano T, Kamiyoshihara M, Takeyoshi I. Segmentectomy guided by three-dimensional computed tomography angiography and bronchography. Interact Cardiovasc Thorac Surg. 2012;15(2):194–6. https://doi.org/10.1093/icvts/ivs202.CrossRefPubMedPubMedCentral

13.

Wu WB, Xu XF, Wen W, Xu J, Zhu Q, Pan XL, Xia Y, Chen L. Three-dimensional computed tomography bronchography and angiography in the preoperative evaluation of thoracoscopic segmentectomy and subsegmentectomy. J Thorac Dis. 2016;8(Suppl 9):S710–5. https://doi.org/10.21037/jtd.2016.09.43.CrossRefPubMedPubMedCentral

14.

Xu G, Chen C, Zheng W, Zhu Y, Zheng B, Chen H. IQQA-3D imaging interpretation and analysis system-guided single-port video-assisted thoracic surgery for anatomical sub-segmentectomy (LS(1+2)a+b). J Thorac Dis. 2018;10(9):5515–21. https://doi.org/10.21037/jtd.2018.08.109.CrossRefPubMedPubMedCentral

15.

Polaczek M, Szaro P, Jakubowska L, Zych J, Religioni J, Orlowski TM. Pulmonary veins variations with potential impact in thoracic surgery: a computed-tomography-based atlas. J Thorac Dis. 2020;12(3):383–93. https://doi.org/10.21037/jtd.2020.01.34.CrossRefPubMedPubMedCentral

16.

Xu XF, Chen L, Wu WB, Zhu Q. Thoracoscopic right posterior segmentectomy of a patient with anomalous bronchus and pulmonary vein. Ann Thorac Surg. 2014;98(6):e127–9. https://doi.org/10.1016/j.athoracsur.2014.09.059.CrossRefPubMed

17.

Akiba T, Morikawa T, Marushima H, Nakada T, Inagaki T, Ohki T. Computed tomography guided thoracoscopic segmentectomy for lung cancer with variant bronchus. Ann Thorac Cardiovasc Surg. 2014;20(5):407–9. https://doi.org/10.5761/atcs.cr.12.02042.CrossRefPubMed

Title: VATS right posterior segmentectomy with anomalous bronchi and pulmonary vessels: a case report and literature review
Authors: Jianbin Zhang
Yilv Zhu
Hongwei Li
Caihua Yu
Weiwei Min
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Computed Tomography
Angiography
Computed Tomography
Bronchography
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01420-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

VATS right posterior segmentectomy with anomalous bronchi and pulmonary vessels: a case report and literature review

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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