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Right upper lobe segmentectomy guided by simplified anatomic models.

Seshiru Nakazawa1, Kimihiro Shimizu2, Natsuko Kawatani1

  • 1Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Japan.

JTCVS Techniques
|July 28, 2021
PubMed
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This summary is machine-generated.

Simplified 3D anatomic models standardize right upper lobe (RUL) segmentectomy. This approach to RUL segmentectomy demonstrated acceptable surgical outcomes and facilitates its clinical implementation.

Area of Science:

  • Thoracic Surgery
  • Surgical Anatomy
  • 3D Modeling

Background:

  • Standardization of technical strategy for right upper lobe (RUL) segmentectomy is crucial.
  • Previously developed simplified 3D anatomic models classify RUL anatomy into 14 patterns based on bronchial and venous branching.
  • The current study evaluates the surgical outcomes of RUL segmentectomy using these simplified anatomic models.

Purpose of the Study:

  • To assess the surgical outcomes of right upper lobe segmentectomy guided by simplified 3D anatomic models.
  • To evaluate the efficacy of a standardized approach for segmental vein identification.
  • To determine the feasibility of implementing RUL segmentectomy using this model-guided strategy.

Main Methods:

  • Retrospective analysis of 34 patients undergoing thoracoscopic RUL segmentectomy between January 2016 and December 2019.
Keywords:
3D, 3-dimensional3D-CTCT, computed tomographyRUL, right upper lobeanatomic modelclassificationright upper lobesegmentectomy

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  • Patients were classified into simplified 3D anatomic models, guiding the approach to intersegmental veins (V1b, V2a, V2c).
  • Clinicopathologic characteristics and short- and long-term outcomes were analyzed.

    • Main Results:

    • All patients were classified into specific anatomic models, with the anterior + central Iab type being most common (47%).
    • Standard approaches to intersegmental veins were utilized, with modifications in 12% of cases.
    • Median operative time was 222 minutes, blood loss 19 grams, and hospital stay 7 days, with one case of prolonged air leakage.

    Conclusions:

    • Segmentectomy guided by simplified anatomic models enhances anatomic classification and standardizes segmental vein identification.
    • This approach yields acceptable surgical outcomes, supporting its clinical utility.
    • The simplified models facilitate the implementation of right upper lobe segmentectomy.