Transection of left common pulmonary vein during left upper lobectomy: how should it be reconstructed?

A common trunk of the left pulmonary vein is an anatomical variation in the pulmonary vessels and may be incidentally transected during left upper lobectomy. Difficulty in reconstruction of the left inferior vein often requires completion pneumonectomy. We herein describe a patient with lung cancer in the left upper lobe of the lung. His common trunk of the left pulmonary vein was incidentally transected with a mechanical stapler during a thoracoscopic left upper lobectomy. The concomitantly transected inferior pulmonary vein was augmented with a cuff technique using an orifice of the superior vein followed by end-to-end anastomosis. The postoperative course was uneventful. This technique should also be considered in patients with lung cancer when a right upper lobe tumor is invading the right superior trunk branching pulmonary veins to the upper and middle lobes.