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Review
. 2021 Mar 29;16(1):60.
doi: 10.1186/s13019-021-01420-2.

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

Jianbin Zhang #  1 , Yilv Zhu #  2 , Hongwei Li  3 , Caihua Yu  1 , Weiwei Min  1
Affiliations
Review

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

Jianbin Zhang et al. J Cardiothorac Surg. .

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.

Keywords: Segmentectomy; Three-dimensional computed tomography bronchography and angiography (3D-CTBA); Video-assisted thoracoscopic surgery (VATS).

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The preoperative computed tomography scanning. A 7-mm ground-glass nodule was identified at the posterior segment of the right upper lobe (arrow), the CT value was -400HU
Fig. 2
Fig. 2
The three-dimensional computed tomography bronchography and angiography. The apical subsegmental bronchi(B1a and B1b) originated from the posterior segmental bronchus (B2) and the anterior segmental bronchus (B3) respectively; The right upper pulmonary artery shared trunk without posterior ascending artery (Asc.A2); The right upper pulmonary vein had no central vein, with only one posterior intrasegmental vein(V2t), the other two veins pointed to the intersegmental plane respectively. a Posterior view; b Lateral view
Fig. 3
Fig. 3
The QR code of Video. VATS right posterior segmentectomy and lymph node sampling
Fig. 4
Fig. 4
The intraoperative view of the posterior segment of the right upper lobe. a Exposed the posterior segmental artery after releasing the segmental hilum sufficiently; b The structure of lung segmental hilum after resection
Fig. 5
Fig. 5
The chest radiograph on the 2nd postoperative day. The incisal margin of the segment displayed no obvious exudation (arrow)
See this image and copyright information in PMC

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