胸腔镜下右肺前基底段切除术伴独特解剖变异：病例报告及文献复习
Thoracoscopic right anterior basal segmentectomy with unique anatomic variation: a case report and literature review.
作者信息
Liu Tiancheng, Huang Sishi, Zhang Jianbin, Jin Lili, Shen Qibin
机构信息
Department of Thoracic Surgery, Huzhou Central Hospital, Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, Zhejiang, China.
Department of Thoracic Surgery, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
出版信息
Front Oncol. 2025 Jun 26;15:1562303. doi: 10.3389/fonc.2025.1562303. eCollection 2025.
BACKGROUND
Anatomic basal segmentectomy is often regarded as a complex procedure, particularly in the presence of complex anatomical variations.
CASE REPORT
Herein, we present a case of a 55-year-old female patient diagnosed with invasive lung adenocarcinoma. Three-dimensional computed tomography bronchography and angiography (3D-CTBA) displayed a unique combined variation in the basal segment of right lower lobe (RLL): The medial basal subsegmental bronchi (BXa+BXt) originated from both the anterior and posterior segmental bronchi; The medial basal subsegmental arteries emanated from the anterior and posterior basal segmental arteries; The medial anterior segmental vein shared a trunk with both the anterior basal and lateral basal subsegmental veins. With precise preoperative planning, thoracoscopic anterior basal segmentectomy was successfully executed.
CONCLUSION
This case again highlights the importance of 3D-reconstruction in pulmonary segmentectomy. Detailed understanding of anatomic features of segmental bronchi and vessels is imperative for those with complex anatomical variations.
背景
解剖性肺段切除术常被视为一种复杂的手术，尤其是在存在复杂解剖变异的情况下。
病例报告
在此，我们报告一例55岁女性患者，诊断为浸润性肺腺癌。三维计算机断层扫描支气管造影和血管造影（3D-CTBA）显示右下叶（RLL）基底段存在独特的联合变异：内侧基底亚段支气管（BXa+BXt）起源于前段支气管和后段支气管；内侧基底亚段动脉发自前基底段动脉和后基底段动脉；前段内侧静脉与前基底亚段静脉和外侧基底亚段静脉共用一个主干。通过精确的术前规划，成功实施了胸腔镜下前基底段切除术。
结论
该病例再次强调了三维重建在肺段切除术中的重要性。对于存在复杂解剖变异的患者，详细了解肺段支气管和血管的解剖特征至关重要。
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