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General Thoracic and Cardiovascular Surgery

, Volume 64, Issue 10, pp 604–611

First Online: 19 July 2016Received: 01 June 2016Accepted: 07 July 2016

Abstract

ObjectiveThoracic surgeons must be erudite pulmonary vein variation when performing anatomical segmentectomy. We used three-dimensional CT 3DCT to accumulate variations of the pulmonary veins of the right upper lobe RUL and created a simplified RUL vein model.

MethodsWe reviewed anatomical variations of the RUL pulmonary veins of 338 patients using 3DCT images, and classified them by position related with bronchus.

ResultsOf the -anterior- and -central- RUL veins, all could be classified into 4 types: 2 Anterior with Central types Iab and Ib, 1 Anterior type, and 1 Central type. The Anterior with Central type was observed in 273 patients 81 %, and was further classified into two types according to the origin of the anterior vein. In the Iab type, the anterior vein originated from V1a to V1b 54 % whereas, in the Ib type, the anterior vein originated from only V1b 26 %. The Central type, which had no anterior vein, was evident in 23 cases 7 %. These three types could be further divided into three subcategories by reference to the branching pattern of the central vein. The Anterior type, which had no central vein, was evident in 42 cases 12 %, and this type could be further categorized into two types, depending on the branching pattern of the anterior vein.

ConclusionWe created a simplified RUL vein model to facilitate anatomical segmentectomy. Our models should find wide application, especially when thoracic surgery requiring anatomical RUL segmentectomy is planned.

KeywordsPulmonary vein Three-dimensional computed tomography Right upper lobe Segmentectomy Electronic supplementary materialThe online version of this article doi:10.1007-s11748-016-0686-4 contains supplementary material, which is available to authorized users.

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Autor: Kimihiro Shimizu - Toshiteru Nagashima - Yoichi Ohtaki - Kai Obayashi - Seshiru Nakazawa - Mitsuhiro Kamiyoshihara - Hitoshi

Fuente: https://link.springer.com/



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