Left superior segmentectomy for a patient with displaced anomalous apicoposterior branches of the pulmonary vein and bronchus: a case report

Abstract

Abstract Background Knowledge of anatomical abnormalities and variations in pulmonary vessels and bronchi is critical for patients requiring a lung segmentectomy. To the best of our knowledge, this is the first case of a tumor existing in the lower lobe in conjunction with a displaced B1+2 in which the B1+2 was not accidentally cut during surgery. Case presentation A 71-year-old woman was referred to our hospital after a part-solid lung cancer was found in the superior segment of her left lung on chest computed tomography. Preoperative three-dimensional computed tomography revealed a displaced anomalous left B1+2 arising from the left main bronchus and anomalous V1+2 returning to the inferior pulmonary vein. We identified these anomalies during surgery and performed a left superior segmentectomy. After an unremarkable recovery, the patient was discharged from the hospital on the eighth day postoperative. Conclusions We used a three-dimensional construction system during the preoperative planning of the pulmonary segmentectomy to better understand the bronchovascular structures. When performing surgery where anatomical abnormalities are present, there is the possibility of misidentification. Using the three-dimensional construction system, it was possible to perform safer surgery, as the surgeons were able to preoperatively prepare for any abnormalities.