Thoracoscopic right anterior basal segmentectomy with unique anatomic variation: a case report and literature review

TL;DR

A 55-year-old woman with lung cancer underwent a complex thoracoscopic surgery made possible by 3D imaging of unique anatomical variations.

Contribution

The case highlights the use of 3D-CTBA for successful segmentectomy in the presence of rare anatomical variations.

Findings

3D-CTBA revealed unique vascular and bronchial variations in the right lower lobe.

Thoracoscopic anterior basal segmentectomy was successfully performed with preoperative 3D planning.

The case emphasizes the importance of detailed anatomical understanding in complex pulmonary surgeries.

Abstract

Anatomic basal segmentectomy is often regarded as a complex procedure, particularly in the presence of complex anatomical variations.

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 (BX7a+BX7t) 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.

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.

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