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Pulmonary vessels and bronchus anatomy of the left upper lobe

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Abstract

Purposes

The bronchopulmonary vascular bifurcation patterns in the upper lobe of the left lung are diverse. Therefore, it is important for general thoracic surgeons to understand the detailed anatomy of the pulmonary segments when performing thoracoscopic anatomical pulmonary resection. This study aimed to analyze the bronchovascular patterns of the left upper lobe and summarize the anatomical information associated with pulmonary anatomical pulmonary resection.

Methods

We reviewed the anatomical patterns of pulmonary vessels and the left lung bronchus of 539 patients using computed tomography imaging data including those obtained using three-dimensional computed tomography. We herein report the anatomic structure in the left upper lobe.

Results

Regarding the superior division bronchi, a pattern of trifurcation into B1+2, B3, lingular division bronchus was observed in nine patients (1.7%). A pattern of proximal bifurcation of B4 was found in eight patients (1.5%). Regarding the lingular veins (LV), patterns of LV drainage into the left lower pulmonary vein were observed in 22 patients (4.1%). Regarding the pulmonary artery, mediastinal lingular arteries (MLA) were found in 161 patients (29.9%).

Conclusion

The bifurcation patterns of the bronchovascular region in the upper lobe of the left lung were clarified. These results should be carefully noted when performing anatomical pulmonary resection.

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Abbreviations

3D-CT:

Three-dimensional computed tomography

LLL:

Left lower lobe

LUL:

Left upper lobe

LD:

Lingular division

LDB:

Lingular division bronchus

LLPV:

Left lower pulmonary veins

LUPV:

Left upper pulmonary veins

LV:

Lingular veins

MLA:

Mediastinal lingular arteries

SD:

Superior division

SDB:

Superior division bronchus

SDV:

Superior division veins

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Authors and Affiliations

  1. Department of Thoracic Surgery, Sapporo Medical University School of Medicine and Hospital, Sapporo, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan

    Ryunosuke Maki, Masahiro Miyajima, Makoto Tada, Yuki Takahashi & Atsushi Watanabe

  2. Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, Sapporo, Japan

    Keishi Ogura

  3. Department of Thoracic Surgery, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Hokkaido, Japan

    Hirofumi Adachi

Authors
  1. Ryunosuke Maki
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  2. Masahiro Miyajima
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  3. Keishi Ogura
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  4. Makoto Tada
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  5. Yuki Takahashi
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  6. Hirofumi Adachi
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  7. Atsushi Watanabe
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Correspondence to Atsushi Watanabe.

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Maki, R., Miyajima, M., Ogura, K. et al. Pulmonary vessels and bronchus anatomy of the left upper lobe. Surg Today 52, 550–558 (2022). https://doi.org/10.1007/s00595-022-02471-1

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  • DOI: https://doi.org/10.1007/s00595-022-02471-1

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