Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Early Diagnosis and Precision Treatment of Lung Cancer, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Hunan Key Laboratory of Early Diagnosis and Precision Treatment of Lung Cancer, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
Asian J Surg. 2024 Oct;47(10):4307-4313. doi: 10.1016/j.asjsur.2024.07.202. Epub 2024 Jul 30.
Segmentectomy has been widely performed in clinical practice, which required a comprehensive understanding of anatomical structure. In right lower lobe, studies of superior segment (S) were relatively small-sized. And only one study focusing on subsuperior segment (S∗) was published, which showed different results with previous ones. As the close relationship between S and S∗, variation types and their prevalence rate were reported, aiming to providing larger-size study of S and showing new evidence on anatomical structure of S∗.
800 CT imaging data were collected from patients in our hospital. Three-dimensional reconstruction was performed after quality check. All images were screened according to the definition of corresponding segment and anatomical variations were analyzed.
The proportion of S variation types in the largest scale (718 patients) was reported with no significant difference compared to previous studies and newly classified subtypes of two-stem V. The prevalence rate for S∗ in right lower lobe reached 28.3 % (203/718) with similar proportion of three types. Variation types and origins of pulmonary artery were analyzed in detail, finding two-stem A∗ only be observed in type III B∗.
Through this study, the variation types and incidence rate of S were confirmed, and a different result of S∗ has been provided as well. The feasibility of the current classification standards and proposed new subclassifications were verified. The results would be a supplement to lung segmental anatomy and could advance researches in the future.
段切除术已在临床实践中广泛应用，这需要对解剖结构有全面的了解。在右下叶中，对上叶段（S）的研究相对较少。只有一项关于下上叶段（S∗）的研究发表，其结果与之前的研究不同。由于 S 和 S∗之间的密切关系，我们报道了它们的变异类型及其流行率，旨在提供更大规模的 S 研究，并展示 S∗解剖结构的新证据。
从我院患者中收集了 800 份 CT 成像数据。经过质量检查后进行三维重建。根据相应段的定义筛选所有图像，并分析解剖变异。
在最大规模（718 例患者）中报告了 S 变异类型的比例，与之前的研究相比无显著差异，并且新分类的两干型 V 亚型也有报道。右下叶 S∗的患病率为 28.3%（203/718），三种类型的比例相似。详细分析了肺动脉的变异类型和起源，发现只有在 III B∗型中才能观察到两干型 A∗。
通过这项研究，证实了 S 的变异类型和发生率，并提供了 S∗的不同结果。当前分类标准的可行性和提出的新亚类得到了验证。研究结果将是对肺段解剖学的补充，并为未来的研究提供帮助。
