Matsumoto Hiroki, Suzuki Hidemi, Toyoda Takahide, Inage Terunaga, Tanaka Kazuhisa, Sakairi Yuichi, Ishibashi Fumihiro, Nakajima Takahiro, Yoshino Ichiro
Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Surg Case Rep. 2021 Jan 6;7(1):8. doi: 10.1186/s40792-020-01097-0.
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 B in which the B was not accidentally cut during surgery.
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 B arising from the left main bronchus and anomalous V 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.
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.
对于需要进行肺段切除术的患者而言，了解肺血管和支气管的解剖异常及变异至关重要。据我们所知，这是首例下叶存在肿瘤且伴有移位支气管（B）的病例，术中该支气管未被意外切断。
一名71岁女性在胸部计算机断层扫描发现左肺上叶部分实性肺癌后转诊至我院。术前三维计算机断层扫描显示，左主支气管发出移位的异常左支气管（B），异常静脉（V）回流至下肺静脉。我们在手术中识别出这些异常并实施了左上叶切除术。术后恢复顺利，患者于术后第8天出院。
我们在肺段切除术的术前规划中使用了三维构建系统，以更好地了解支气管血管结构。在存在解剖异常的情况下进行手术时，有可能出现误认。使用三维构建系统能够进行更安全的手术，因为外科医生能够在术前针对任何异常情况做好准备。
