Abstract
We herein reported a case of a dangerous anomaly of a pulmonary vein in subcarinal dissection. A 74-year-old man underwent esophagectomy with systematic nodal dissection using a laparoscopic transhiatal approach. Under pneumomediastinum pressure, dissection of the posterior plane of the pericardium was extended, and a vessel that independently drained into the left atrium was identified. Although this anomalous vein penetrated the subcarinal lymph nodes and crossed behind the right main bronchi, subcarinal dissection was successfully performed without its injury. Our surgical procedure enabled the intraoperative identification of this rare abnormality, an aberrant segmental vein in the right upper lobe, and safe en bloc subcarinal dissection.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Shiozaki A, Fujiwara H, Konishi H, Morimura R, Murayama Y, Komatsu S, et al. Novel technique for dissection of subcarinal and main bronchial lymph nodes using a laparoscopic transhiatal approach for esophageal cancer. Anticancer Res. 2013;33:2577–85.
Asai K, Urabe N, Yajima K, Suzuki K, Kazui T. Right upper lobe venous drainage posterior to the bronchus intermedius: preoperative identification by computed tomography. Ann Thorac Surg. 2005;79:1866–71.
Matsubara T. Rare but dangerous anomaly of the right pulmonary vein in subcarinal dissection. Ann Thorac Surg. 2003;75:1026.
Shiozaki A, Fujiwara H, Murayama Y, et al. Perioperative outcomes of esophagectomy preceded by the laparoscopic transhiatal approach for esophageal cancer. Dis Esophagus. 2014;27:470–8.
Kim JS, Choi D, Lee KS. CT of the bronchus intermedius: frequency and cause of a nodule in the posterior wall on normal scans. Am J Roentgenol. 1995;165:1349–52.
Tsunezuka Y, Furusawa T, Yachi T. Subsegmental pulmonary vein V6a from independent aberrant segmental vein V2 posterior to the bronchus intermedius. Eur J Cardiothorac Surg. 2012;42:751.
Usami N, Iwano S, Mizuno T, Taniguchi T, Yokoi K. Three-dimensional angiography of aberrant segmental vein of right upper lobe. Asian Cardiovasc Thorac Ann. 2010;18:398.
Ishikawa Y, Iwano S, Usami N, Yokoi K. An anomalous segmental vein of the left upper lobe of the lung: preoperative identification by three-dimensional computed tomography pulmonary angiography. Interact Cardiovasc Thorac Surg. 2012;15:512–3.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None declared.
Rights and permissions
About this article
Cite this article
Shiozaki, A., Fujiwara, H., Konishi, H. et al. Successful subcarinal dissection using a laparoscopic transhiatal approach for esophageal cancer with an anomalous pulmonary vein. Gen Thorac Cardiovasc Surg 64, 239–242 (2016). https://doi.org/10.1007/s11748-016-0628-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-016-0628-1