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Left S3 + S8 Segmentectomy with Rare Interlobar A3 Vascular Anomaly: A Case Report
Hiroki Imabayashi1, Takahide Toyoda1, Kazuhisa Tanaka1
1Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba, Chiba, Japan.
Surgical Case Reports
|May 7, 2025
Summary
A rare left A3 pulmonary artery variation requires specific surgical techniques during segmentectomy for lung cancer. This case highlights the importance of understanding anatomical anomalies for safe and effective lung cancer surgery.
Area of Science:
- Thoracic Surgery
- Surgical Anatomy
- Pulmonary Medicine
Background:
- Segmentectomy is an accepted procedure for small non-small cell lung cancer.
- Understanding pulmonary artery (PA) variations is crucial for safe lung surgeries.
- Anatomic variations of the pulmonary arteries can complicate surgical planning.
Observation:
- A patient presented with nodules in left S3 and S8, suggestive of double primary lung cancer.
- Preoperative imaging revealed a rare complete interlobar branch of the left A3.
- This anomaly, where left A3 branches from the interlobar PA, occurs in less than 0.56% of cases.
Findings:
- Left S3 and S8 segmentectomies were successfully performed despite the anomalous left A3.
- The interlobar A3 branched at a level similar to the left A6.
- Special precautions were taken to prevent lung torsion in the remaining segments.
Implications:
- Complete interlobar branching of the left A3 is an uncommon finding.
- Left S3 segmentectomy with this anomaly necessitates careful management of remaining lung segments.
- Awareness of this PA variation is vital for preventing complications during lung segment resection.
