Anatomical branches of right upper lobe pulmonary arteries in Chinese patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YAN Shi , WU Nan , WANG Xing , LV Chao , LI Shaolei , WANG Jia , WANG Yuzhao , WANG Yaqi ,  YANG Yue

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery Ⅱ, Peking University Cancer Hospital & Institute, Beijing, 100142, P.R.China;

Corresponding author：

YANG Yue, Email: zlyangyue@bjmu.edu.cn

Keywords：

Right upper lobe; branches of the pulmonary artery; apicoanterior segmental artery; ascending segmental artery

DOI：

10.7507/1007-4848.201708025

Video：

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Objective To observe and describe anatomical types of the pulmonary arteries to keep safety of lung resection. Methods Between November 25, 2005 and January 22, 2013, 194 patients who underwent right upper lobectomy/sleeve lobectomy or combined lung resection including right upper lobectomy were included in Peking University Cancer Hospital. There were 128 males with a median age of 59 (37-86) years and 66 females with a median age of 60 (42-77) years. We separated the pulmonary arteries and recorded the number and positions of them. Some patients were recorded photographically. Results There were 10 types of right upper lobe pulmonary artery branches in this study. Type 1: 1 apicoanterior segmental artery, 1 ascending segmental artery, 96 patients (49.5%); Type 2: 1 apicoanterior segmental artery, 2 ascending segmental arteries, 48 patients (24.7%); Type 3: 2 apicoanterior segmental arteries, 1 ascending segmental artery, 28 patients (14.4%); Type 4: 2 apicoanterior segmental arteries, 2 ascending segmental arteries, 9 patients (4.6%); Type 5: 1 apicoanterior segmental artery only, 6 patients (3.1%); Type 6: 1 apicoanterior segmental artery, 3 ascending segmental arteries, 3 patients (1.5%); Type 7: 4 apicoanterior segmental arteries, 1 ascending segmental artery, 1 patient (0.5%); Type 8: 3 apicoanterior segmental arteries, 1 ascending segmental artery, 1 patient (0.5%); Type 9: 2 apicoanterior segmental arteries, 1 patient (0.5%); Type 10: 3 apicoanterior segmental arteries, 2 ascending segmental arteries, 1 patient (0.5%). Conclusion The types of pulmonary artery branches are predictable in some way. It would be helpful to reduce the risk of pulmonary artery injury and improve the operation safety by following the rules. Variations of pulmonary artery should be noticed to avoid the major bleeding due to the pulmonary artery injury.

Citation： YAN Shi, WU Nan, WANG Xing, LV Chao, LI Shaolei, WANG Jia, WANG Yuzhao, WANG Yaqi, YANG Yue. Anatomical branches of right upper lobe pulmonary arteries in Chinese patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(7): 567-571. doi: 10.7507/1007-4848.201708025 Copy

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1. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017, 67(1):7-30.
2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer, 2013, 49(6):1374-403.
3. Chen WQ, Zheng RS, Hongmei TT, et al. National cancer incidence and mortality in China, 2012. Chin J Cancer Res. 2015, 28(1):38-43.
4. Naef AP. Hugh Morriston Davies: first dissection lobectomy in 1912. Ann Thorac Surg, 1993, 56(4): 988-989.
5. Subotich D, Mandarich D, Milisavljevich M, et al. Variations of pulmonary vessels: some practical implications for lung resections. Clin Anat, 2009, 22(6): 698-705.
6. Cheng D, Downey RJ, Kernstine K, et al. Video-assisted thoracic surgery in lung cancer resection: a meta-analysis and systematic review of controlled trials. Innovations (Phila), 2007, 2(6): 261-292.
7. Whitson BA, Andrade RS, Boettcher A, et al. Video-assisted thoracoscopic surgery is more favorable than thoracotomy for resection of clinical stage I non-small cell lung cancer. Ann Thorac Surg, 2007, 83(6): 1965-1970.
8. Whitson BA, Groth SS, Duval SJ, et al. Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg, 2008, 86(6): 2008-2016.
9. Swanson SJ, Batirel HF. Video-assisted thoracic surgery (VATS) resection for lung cancer. Surg Clin North Am, 2002, 82(3): 541-559.
10. Bendixen M, Jørgensen OD, Kronborg C, et al. Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. Lancet Oncol, 2016, 17(6): 836-844.
11. Dunning J, Walker WS. Pulmonary artery bleeding caused during VATS lobectomy. Ann Cardiothorac Surg, 2012, 1(1): 109-110.
12. Byun CS, Lee S, Kim DJ, et al. Analysis of unexpected conversion to thoracotomy during thoracoscopic lobectomy in lung cancer. Ann Thorac Surg, 2015, 100(3): 968-973.
13. Puri V, Patel A, Majumder K, et al. Intraoperative conversion from video-assisted thoracoscopic surgery lobectomy to open thoracotomy: a study of causes and implications. J Thorac Cardiovasc Surg, 2015, 149(1): 55-61.
14. 陈尔瑜, 何光箎, 刘正津, 等. 中国人肺的支气管和血管, 一、右肺上叶的支气管和血管. 解剖学报, 1960, 5(1): 30-49.
15. 石中梁. 中国人肺动脉分支的观察. 徐州医学院学报, 1980, 1: 1-9.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Anatomical branches of right upper lobe pulmonary arteries in Chinese patients

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