Lobectomy for lung cancer with a displaced left B and an anomalous pulmonary vein: a case report.

BACKGROUND

A displaced left B 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 and hyperlobulation between S and S, while the interlobar fissure between S and S was completely fused. Three-dimensional computed tomography (3D-CT) revealed an anomalous V joining the left inferior pulmonary vein and a branch of the V running between S and S. 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 and confirm the locations of B and B when dividing the fissure.

CONCLUSION

The aim of the surgical procedure performed in this case was to divide the fissure between S 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.