Pulmonary vessels and bronchus anatomy of the left upper lobe

Maki, Ryunosuke; Miyajima, Masahiro; Ogura, Keishi; Tada, Minoru; Takahashi, Yuki; Adachi, Hirofumi; Watanabe, Atsushi

doi:10.1007/s00595-022-02471-1

Cited by 7 publications

(23 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, there are only a few reports that have comprehensively summarized and classified the bronchovascular pattern of LS using 3D-CTBA. In this study, we analyzed the bronchovascular patterns of the LS and emphasized the differences between our results and those of previous reports (8)(9)(10)(11)(12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 67%

“…In this study, the origins of LSB were divided into two types (Table 1, Figure 1). B4 from the central division of the upper lobe bronchus and B5 from the inferior division of the upper lobe bronchus was a rare anomaly (4.4%), which has not been reported in the literature (8,9,12). Thus, it is extremely easy to mistake the inferior division of the upper lobe bronchus (B5) for B4 + B5 during LS segmentectomy, which will narrow the intersegmental plane.…”

Section: Discussionmentioning

confidence: 98%

“…However, there are only a few studies describing anatomic variations of the lingular segment (LS) using three-dimensional computed tomography bronchography and angiography (3D-CTBA) (8). In our clinical practice, the anatomical variation of the lingular segment bronchus (LSB) does not accordant with the previous reports (9,10). Moreover, the more detailed classification and occurrence probability of the branching patterns of LSA has been rarely involved in previous studies (11)(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Analysis of variations in the bronchovascular pattern of the lingular segment to explore the correlations between the lingular segment artery and left superior division veins

Kong

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

BackgroundWith the development of anatomical segmentectomy, the thoracic surgeons must master the anatomical variations of the pulmonary bronchi and vessels. However, there are only a few reports showing anatomic variations of the lingular segment (LS) using three-dimensional computed tomography bronchography and angiography (3D-CTBA). Thus, the present study aimed to analyze the bronchovascular patterns of the LS and explore the correlation between the lingular segment artery (LSA) and left superior division veins (LSDV).Materials and methodsThe 3D-CTBA data of the left upper lobe (LUL) were collected from patients who had undergone lobectomy or segmentectomy at Hebei General Hospital between October 2020 and October 2022. We reviewed the clinical characteristics and variations in bronchi and pulmonary vessels and grouped them according to different classifications.ResultsAmong all 540 cases of 3D-CTBA, the branching patterns of LSA included 369 (68.3%) cases with the interlobar origin, 126 (23.3%) cases with the interlobar and mediastinal origin, and 45 (8.3%) cases with the mediastinal origin. The branching pattern of LSDV could be classified into three forms: Semi-central vein type (345/540, 63.9%), Non-central vein type (76/540, 14.1%), and Central vein type (119/540, 22.0%). There were 51 cases (9.4%) with Non-central vein type, 50 cases (9.3%) with Central vein type, 268 cases (49.6%) with Semi-central vein type in the interlobar type, and 7 cases (1.3%) with Non-central vein type, 9 cases (1.7%) with Central vein type, 29 cases (5.4%) with Semi-central vein type in the mediastinal type. Moreover, the Non-central vein type, the Central vein type, and the Semi-central vein type accounted for 18 (3.3%), 60 (11.1%), and 48 (8.9%) in the interlobar and mediastinal type. Combinations of the branching patterns of the LSA and LSDV were significantly dependent (p < 0.005). The combinations of the interlobar and mediastinal type with the Central vein type, and the interlobar type and the mediastinal type with the Semi-central vein type were frequently observed.ConclusionsThis study found the relationship between the LSA and LSDV and clarified the bifurcation patterns of the bronchovascular in the LS. Our data can be used by thoracic surgeons to perform safe and precise LS segmentectomy.

show abstract

Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Analysis of variations in the bronchovascular pattern of the lingular segment to explore the correlations between the lingular segment artery and left superior division veins

Kong

et al. 2023

Front. Surg.

View full text Add to dashboard Cite

show abstract

“…2 Although several branch types have been recently reported, the central vein type is still very rare (2.9% and 2.8%). 3 , 4 The pulmonary parenchyma is usually easily divided between S 1+2 and S 3 along the intersegmental vein with the anterior approach in the apical or apicocentral vein types because these veins run through the anterior site. In the central vein type, pulmonary veins run posterior to A 3 .…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic anatomic left S1+2ab subsegmentectomy involving the left upper pulmonary vein of the central vein type

Kato¹,

Abiko²

2022

JTCVS Techniques

View full text Add to dashboard Cite

“…Confusion between RA 7 and RA 10 , RA 8 and RA 9 , LA 9 and LA 10 are mostly seen. In some publications (13)(14)(15), absent basal segmental arteries such as A 7 or A 9 were reported but not well defined. For A 7 absent, we found it extremely rare and did not encounter any case with a suspicious absent A 7 yet.…”

Section: Ra* 7%mentioning

confidence: 99%

An atlas of anatomical variants of subsegmental pulmonary arteries and recognition error analysis

Zhao

Jin

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

BackgroundSurgery, including lobectomy and segmentectomy, is the major curative intervention for lung cancer. Surgical planning for pulmonary surgery is difficult due to the high variation rate of pulmonary arteries and needs a fine-grained atlas as a reference. We conducted a study to create a surgically oriented atlas and analyzed the error encountered during the production.MethodA total of 100 Chest CTs performed at Peking University People’s Hospital from 2013.09 to 2020.10 were randomly selected for segmental artery labeling. Dicom files were collected for 3D reconstruction. Manual segmentation of each segmental artery was performed by 4 thoracic surgeons. Cross-validation by surgeons was performed to establish the golden standard based on their consensus. Initial recognition errors were recorded accordingly.ResultThe most frequently seen variants for the right upper lobe is 2-branch RA1+2rec+3 and RA2asc; right middle lobe 2-branch RA4a and RA4b+5; right lower lobe 3-branch RA7, RA8 and RA9+10; left upper lobe 3-branch LA1+2a+3, LA1+2b, LA1+2c and 1-branch LA4+5; left lower lobe 2-branch LA8 and LA9+10. Top 5 segmental error occurs in RA4 (23%), LA8 (17%), RA9 (17%), RA8 (14%) and LA9 (11%). A rapid surgical planning tool form was created based on high frequency anatomic variants.ConclusionOur research provided an atlas for lobectomy and segmentectomy at the subsegmental or more distal level. We demonstrated that the recognition accuracy of pulmonary arteries in a non-time-sensitive experimental scenario was still unfavorable. We also suggest that extra attention should be paid to certain surgeries during the surgical planning process.

show abstract

Pulmonary vessels and bronchus anatomy of the left upper lobe

Cited by 7 publications

References 19 publications

Analysis of variations in the bronchovascular pattern of the lingular segment to explore the correlations between the lingular segment artery and left superior division veins

Analysis of variations in the bronchovascular pattern of the lingular segment to explore the correlations between the lingular segment artery and left superior division veins

Thoracoscopic anatomic left S1+2ab subsegmentectomy involving the left upper pulmonary vein of the central vein type

An atlas of anatomical variants of subsegmental pulmonary arteries and recognition error analysis

Contact Info

Product

Resources

About