Right upper lobe segmentectomy and subsegmentectomy guided by classification pattern of peripheral segmental veins.

Area of Science:

• Thoracic surgery
• Radiology
• Anatomy

Background:

• Previous studies focused on intersegmental vein identification in the right upper lobe (RUL).
• Identification approaches for intersubsegmental veins remained unreported.
• This study addresses the need for a comprehensive classification and identification strategy for RUL veins.

Purpose of the Study:

• To classify peripheral segmental veins in the RUL.
• To develop and supplement identification approaches for intersegmental and intersubsegmental veins.
• To enhance anatomical understanding for precise RUL segmentectomy.

Main Methods:

• Retrospective analysis of 600 patients with ground glass opacity (GGO).
• Utilized three-dimensional computed tomography bronchography and angiography (3D-CTBA) for detailed imaging.
• Reviewed anatomical variations of RUL veins.

Main Results:

• Peripheral segmental veins of the RUL were classified into five categories based on anatomical position.
• Five distinct approaches for identifying intersegmental and intersubsegmental veins were established.
• Prevalence of each vein type was quantified.

Conclusions:

• The proposed classification and identification methods offer a standardized approach.
• These findings can significantly aid thoracic surgeons in performing safe and accurate RUL segmentectomies.
• This research contributes valuable anatomical insights for pulmonary surgical procedures.