Thoracoscopic Lobectomy for Treating Cancer in a Patient with an Unusual Vein Anomaly

Akiba, Tadashi; Marushima, Hideki; Kamiya, Noriteru; Odaka, Makoto; Kinoshita, Satoki; Takeyama, Hiroshi; Kobayashi, Susumu; Morikawa, Toshiaki

doi:10.5761/atcs.cr.10.01595

Cited by 12 publications

(9 citation statements)

References 8 publications

(8 reference statements)

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“…In particular, aberrant V 6 was not identified in previous reports. These minor anatomical variations in pulmonary veins can cause serious problems in patients undergoing lung surgery [7, 8]. For example, during right lower lobectomy in a patient with aberrant V 4+5 , if we cut an IPV with an aberrant V 4+5 , the right middle lobe would become dysfunctional after surgery.…”

Section: Discussionmentioning

confidence: 99%

Analysis of variation in bronchovascular pattern of the right middle and lower lobes of the lung using three-dimensional CT angiography and bronchography

Nagashima

Shimizu

Ohtaki

et al. 2017

Gen Thorac Cardiovasc Surg

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ObjectivesGeneral thoracic surgeons must be familiar with anatomical variation in the pulmonary vessels and bronchi. Here, we analyzed the bronchovascular pattern of the right middle lobe (RML) and right lower lobe (RLL) of the lung using three-dimensional CT angiography and bronchography (3DCTAB).MethodsWe reviewed the anatomical patterns of the pulmonary vessels and bronchi in 270 patients using 3DCTAB images.ResultsThe branching patterns of vessels and bronchi of RML and S6 were classified according to the number of stems. The single-stem type was the most common, except in the artery of the RML, for which the two-stem type was the most common. The artery and bronchus of S*, which is an independent segment between S6 and S10, were observed in 20.4% of cases. The branching pattern of A7 (B7) was classified into four types. The A7a (B7a) type was observed in 74.8% of cases, and was the most common. The branching pattern of the artery and bronchus of S8−10 was classified into five and three types, respectively. The A8 and A9 + A10 type, and the B8 and B9 + B10 type, were observed in 68.1 and 80.4% of cases, respectively, and were the most common types. The branching pattern of V8−10 was more complex than that of A8−10 and B8−10.ConclusionWe explored the bronchovascular patterns of RML and RLL and their frequencies using a large number of 3DCTAB images. Our data can be used by thoracic surgeons to perform safe and precise lung resections.Electronic supplementary materialThe online version of this article (doi:10.1007/s11748-017-0754-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Analysis of variation in bronchovascular pattern of the right middle and lower lobes of the lung using three-dimensional CT angiography and bronchography

Nagashima

Shimizu

Ohtaki

et al. 2017

Gen Thorac Cardiovasc Surg

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“…Preoperative identification of anomalous pulmonary vessels is thought to be important for avoiding injury to vessels and for further understanding of pulmonary anatomy. [1][2][3][4][5] Therefore, preoperative simulation of the surgical anatomy using imaging modalities is desirable. There are various advantages of this 3D-CT software that is based on volume-rendering techniques.…”

Section: Discussionmentioning

confidence: 99%

High-quality 3-dimensional imaging for patients with anomalous pulmonary veins

Fukuta

Shimada

Hagiwara

et al. 2014

Asian Cardiovasc Thorac Ann

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The branching pattern of pulmonary veins exhibits many variations. Here we describe 2 patients with lung malignancies who were found to have pulmonary vein anomalies. We performed video-assisted thoracoscopic lobectomies based on preoperative simulations by 3-dimensional computed tomography. Using 3-dimensional computed tomography, a surgeon can easily construct digital images of the patient's pulmonary vessels within a few minutes. Simulation using 3-dimensional computed tomography imaging is useful for further understanding of the surgical anatomy.

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“…Suggested techniques to increase the safety of stapler passage include use of a red-rubber catheter (8)(9)(10)(11)(12)(13)(14) or a Penrose drain to guide the anvil, or use of silk sutures or vessel loops to maximize the space for anvil passage around the vessels. 29,57,58 Due to the low pressure pulmonary system, control of minor bleeding or oozing from staple lines, minor vasculature injuries, or parenchymal injuries often may be addressed adequately with a period of applied pressure.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Less common venous drainage abnormalities reported include a common ostium for the left and right inferior pulmonary veins, 11,12 a lingular vein draining to the lower pulmonary vein, 13 a lateral segment vein of the middle lobe draining to the inferior pulmonary vein, and a superior segment vein draining directly into the left atrium. 4,14 Given the variability in the pulmonary venous drainage, some investigators have recommended routine formal preoperative venous system assessment with CT in all patients. 15 Some investigators have reported on the utility of preoperative CT for surgical planning 16 before thymectomy.…”

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confidence: 99%