Key result
Using 3D-CTBA, the peripheral segmental veins of the right upper lobe were classified into five categories, with the 'Iab type of anterior with central vein' being the most common.
Why the study?
Although a standardized approach for RUL intersegmental vein identification exists, the identification approach for intersubsegmental veins had not been reported.
Observational (n=600)
No
3D-CTBA classification of right upper lobe peripheral segmental veins into five types provides a standardized approach to identify intersegmental and intersubsegmental veins for safe anatomical segmentectomy.
Answers are grounded in this paper and cite their sources.
May guide preoperative planning for RUL segmentectomy; leaves open prospective validation of safety and outcomes.
Background Studies have analyzed the simplified branching pattern of peripheral segmental veins and developed a standardized approach for intersegmental vein identification in the right upper lobe (RUL). However, the identification approach of intersubsegmental veins has not been reported. This study aimed to supplement the identification approach of intersubsegmental veins and the classification pattern of peripheral segmental veins by using three-dimensional computed tomography bronchography and angiography (3D-CTBA). Materials and methods A total of 600 patients with ground glass opacity (GGO) who had undergone 3D-CTBA preoperatively at Hebei General Hospital between September 2020 and September 2022 were used for the retrospective study. We reviewed the anatomical variations of RUL veins in these patients using 3D-CTBA images. Results According to the anatomical position, the peripheral segmental veins structures of RUL were classified into five categories: “Iab type of anterior with central vein” (256/600, 42.7%), “Ib type of anterior with central vein” (166/600, 27.7%), “Central vein type” (38/600, 6.3%), “Anterior vein type” (81/600, 13.5%), “Right top pulmonary vein type” (57/600, 9.5%). The approach for intersegmental vein and intersubsegmental veins identification was divided into five types: anterior approach, posterobronchial approach, central vein approach, V2t approach, and intermediate bronchus posterior surface approach. Conclusions The classification pattern of peripheral segmental veins should find wide application. Further, approaches identifying intersegmental veins and intersubsegmental veins may help thoracic surgeons perform safe and accurate RUL segmentectomy.
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Li et al. (2023) conducted an observational in Ground glass opacity (GGO) (n=600). 3D-CTBA evaluation of right upper lobe peripheral segmental veins was evaluated on Classification pattern of peripheral segmental veins of the right upper lobe. Using 3D-CTBA, the peripheral segmental veins of the right upper lobe were classified into five categories, with the 'Iab type of anterior with central vein' being the most common.
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