Abstract
BackgroundA clear understanding of the anatomical characteristics of the pulmonary veins (PVs) is essential for the successful performance of segmentectomy and important to avoid intraoperative pulmonary vessels injury. However, there is no report showing the relations between the branching patterns of PVs and pulmonary arteries (PAs). Moreover, internationally accepted symbols for describing PVs remain unavailable. For anatomically assessing the branches and courses of the subsegmental veins in the left upper lobe (LUL), the diverse branching patterns of blood vessels and bronchi should be investigated.MethodsThe branching patterns and intersegmental courses of PVs were assessed by performing three-dimensional image analysis of the bronchi, and PAs and PVs in the LUL in 103 patients who were scheduled to receive segmentectomy in LUL from January 2008 through August 2012.ResultsBranching types of the bronchi and pulmonary vessels failed to be independent each other. Although the combinations of anterior extension type of bronchus with the inter-lobar type (IL-type) of arterial branching pattern were often observed, but those with the mediastinal type (M-type) were rarely observed. The combinations of apical vein dominant type with the IL-type of arteries, and intermediate and central vein types with the M-type were often observed. Since LUL was adjoined by various subsegments, and the intersegmental pulmonary veins showed diverse patterns.ConclusionsThis study found the relationship among PA, PV, and bronchus patterns, in the subsegment where the branching patterns were fixed in 103 cases. This study discovered PVs that was difficult to be named by the conventional naming systems because of the diversity of the locations in the subsegment.
Highlights
A clear understanding of the anatomical characteristics of the pulmonary veins (PVs) is essential for the successful performance of segmentectomy and important to avoid intraoperative pulmonary vessels injury
An intraoperative vessels injury was more frequent during the left upper lobectomy [15,16,17], this study anatomically analyzed the branches and courses of subsegmental PVs, which are characterized by considerable diversity in the branching patterns of blood vessels and bronchi, in the left upper lobe (LUL) of lung
In 103 patients, apico-anterior extension type was found in 33 patients (32.0%); subapico-anterior extension type, in 49 patients (47.6%); anterior extension type, in 21 patients (20.3%) (Table 1). (2) Branching patterns of Pulmonary artery (PA)
Summary
A clear understanding of the anatomical characteristics of the pulmonary veins (PVs) is essential for the successful performance of segmentectomy and important to avoid intraoperative pulmonary vessels injury. For anatomically assessing the branches and courses of the subsegmental veins in the left upper lobe (LUL), the diverse branching patterns of blood vessels and bronchi should be investigated. Pulmonary segmentectomy is developed as a surgical procedure for treating infection such as tuberculosis and bronchiectasis arising primarily in the bronchi This procedure is used for treating small peripheral lung cancers, metastatic lung tumors, benign lung tumors, and inflammatory diseases [1,2,3,4,5,6]. An intraoperative vessels injury was more frequent during the left upper lobectomy [15,16,17], this study anatomically analyzed the branches and courses of subsegmental PVs, which are characterized by considerable diversity in the branching patterns of blood vessels and bronchi, in the left upper lobe (LUL) of lung
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