Lobectomy for lung cancer with a displaced left B1 + 2 and an anomalous pulmonary vein: a case report

Background A displaced left B.sup.1 + 2 accompanied by an anomalous pulmonary vein is a rare condition involving complex structures. There is a risk of unexpected injuries to bronchi and blood vessels when patients with such anomalies undergo surgery for lung cancer. Case presentation A 59-year-old...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery 2021-01, Vol.16 (1), p.1-15, Article 15
Main Authors: Sakamoto, Shinichi, Takizawa, Hiromitsu, Kawakita, Naoya, Tangoku, Akira
Format: Article
Language:English
Subjects:
Anomalies
Anomalous pulmonary vein
Blood vessels
Bronchi
Bronchus
Case Report
Computed tomography
CT imaging
Displaced bronchus
Displacement
Health risks
Injury prevention
Lung cancer
Lymphatic system
Patients
Pulmonary arteries
Surgeons
Surgery
Thoracic surgery
Thorax
Tomography
Veins
Veins & arteries
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Summary:Background A displaced left B.sup.1 + 2 accompanied by an anomalous pulmonary vein is a rare condition involving complex structures. There is a risk of unexpected injuries to bronchi and blood vessels when patients with such anomalies undergo surgery for lung cancer. Case presentation A 59-year-old male with suspected lung cancer in the left lower lobe was scheduled to undergo surgery. Chest computed tomography revealed a displaced B.sup.1 + 2 and hyperlobulation between S.sup.1 + 2 and S.sup.3, while the interlobar fissure between S.sup.1 + 2 and S.sup.6 was completely fused. Three-dimensional computed tomography (3D-CT) revealed an anomalous V.sup.1 + 2 joining the left inferior pulmonary vein and a branch of the V.sup.1 + 2 running between S.sup.1 + 2 and S.sup.6. We performed left lower lobectomy via video-assisted thoracic surgery, while taking care with the abovementioned anatomical structures. The strategy employed in this operation was to preserve V.sup.1 + 2 and confirm the locations of B.sup.1 + 2 and B.sup.6 when dividing the fissure. Conclusion The aim of the surgical procedure performed in this case was to divide the fissure between S.sup.1 + 2 and the inferior lobe to reduce the risk of an unexpected bronchial injury. 3D-CT helps surgeons to understand the stereoscopic positional relationships among anatomical structures. Keywords: Displaced bronchus, Anomalous pulmonary vein, Lung cancer
ISSN:1749-8090
1749-8090
DOI:10.1186/s13019-021-01392-3