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Inter-multisegmental veins (IMSVs): a new positional indication for pulmonary segmentectomy.

Chengyu Bian1,2, Chenghao Fu2, Yuheng Wang2

  • 1Department of Thoracic Surgery, The First People's Hospital of Changzhou and The Third Affiliated Hospital of Soochow University, Changzhou, China.

Journal of Thoracic Disease
|March 14, 2025
PubMed
Summary
This summary is machine-generated.

This study identifies key positional indicators for sublobar resection in non-small cell lung cancer (NSCLC) patients. Understanding inter-multisegmental veins (IMSVs) and lesion location optimizes surgical strategy for better outcomes.

Keywords:
Pulmonary noduleinter-multisegmental vein (IMSV)sublobar resectionthree-dimensional reconstruction (3D reconstruction)

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Sublobar resection is increasingly favored for early-stage lung cancer.
  • Surgical strategies for resecting tumors near inter-multisegmental veins (IMSVs) are underreported.
  • Clarifying positional indications for sublobar resection in non-small cell lung cancer (NSCLC) is crucial.

Purpose of the Study:

  • To define positional indications for sublobar resection in clinical T1a-bN0 NSCLC.
  • To analyze the prevalence and drainage patterns of inter-multisegmental veins (IMSVs).
  • To investigate the association between lesion location and surgical strategy selection.

Main Methods:

  • Retrospective analysis of 686 NSCLC patients (August 2021-July 2022).
  • Utilized 3D reconstruction to analyze prevalence and drainage of IMSVs, focusing on lateral vein (Vl) and superior segmental vein (V⁶b) branches.
  • Assessed the relationship between lesion characteristics, proximity to IMSVs, and surgical approach.

Main Results:

  • High prevalence of Vl (58.5%), V⁶b2 (98.3%), and V⁶b3 (25.1%) observed.
  • Vl demonstrated varied drainage patterns; V⁶b2 and V⁶b3 showed consistent convergence.
  • Limited resection feasibility correlated with non-involvement of IMSVs within a 2 cm margin and peripheral lesion location.

Conclusions:

  • Inter-multisegmental veins (IMSVs) are prevalent with distinct drainage characteristics.
  • Depth ratio and relative lesion location to IMSVs serve as critical positional indications for sublobar resection.
  • These findings aid in selecting appropriate surgical strategies for T1a-bN0 NSCLC patients undergoing sublobar resection.