{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T22:14:55Z","timestamp":1772057695909,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>With the development of anatomical segmentectomy, the thoracic surgeons must master the anatomical variations of the pulmonary bronchi and vessels. However, there are only a few reports showing anatomic variations of the lingular segment (LS) using three-dimensional computed tomography bronchography and angiography (3D-CTBA). Thus, the present study aimed to analyze the bronchovascular patterns of the LS and explore the correlation between the lingular segment artery (LSA) and left superior division veins (LSDV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>The 3D-CTBA data of the left upper lobe (LUL) were collected from patients who had undergone lobectomy or segmentectomy at Hebei General Hospital between October 2020 and October 2022. We reviewed the clinical characteristics and variations in bronchi and pulmonary vessels and grouped them according to different classifications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among all 540 cases of 3D-CTBA, the branching patterns of LSA included 369 (68.3%) cases with the interlobar origin, 126 (23.3%) cases with the interlobar and mediastinal origin, and 45 (8.3%) cases with the mediastinal origin. The branching pattern of LSDV could be classified into three forms: Semi-central vein type (345\/540, 63.9%), Non-central vein type (76\/540, 14.1%), and Central vein type (119\/540, 22.0%). There were 51 cases (9.4%) with Non-central vein type, 50 cases (9.3%) with Central vein type, 268 cases (49.6%) with Semi-central vein type in the interlobar type, and 7 cases (1.3%) with Non-central vein type, 9 cases (1.7%) with Central vein type, 29 cases (5.4%) with Semi-central vein type in the mediastinal type. Moreover, the Non-central vein type, the Central vein type, and the Semi-central vein type accounted for 18 (3.3%), 60 (11.1%), and 48 (8.9%) in the interlobar and mediastinal type. Combinations of the branching patterns of the LSA and LSDV were significantly dependent (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.005). The combinations of the interlobar and mediastinal type with the Central vein type, and the interlobar type and the mediastinal type with the Semi-central vein type were frequently observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study found the relationship between the LSA and LSDV and clarified the bifurcation patterns of the bronchovascular in the LS. Our data can be used by thoracic surgeons to perform safe and precise LS segmentectomy.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2023.1173602","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T22:29:02Z","timestamp":1682029742000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Analysis of variations in the bronchovascular pattern of the lingular segment to explore the correlations between the lingular segment artery and left superior division veins"],"prefix":"10.3389","volume":"10","author":[{"given":"Zhikai","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenbo","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhong","family":"Kong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuangqing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaopeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/j.jtcvs.2020.09.146","article-title":"A single-arm study of sublobar resection for ground-glass opacity dominant peripheral lung cancer","volume":"163","author":"Suzuki","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1055\/s-0030-1250377","article-title":"Comparison of the surgical outcomes of thoracoscopic lobectomy, segmentectomy, and wedge resection for clinical stage I non-small cell lung cancer","volume":"59","author":"Nakamura","year":"2011","journal-title":"Thorac Cardiovasc Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2449","DOI":"10.1200\/JCO.2013.50.8762","article-title":"Recurrence and survival outcomes after anatomic segmentectomy versus lobectomy for clinical stage I non-small-cell lung cancer: a propensity-matched analysis","volume":"32","author":"Landreneau","year":"2014","journal-title":"J Clin Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/resp.13277","article-title":"Segmentectomy versus lobectomy in early non-small cell lung cancer of 2\u2005cm or less in size: a population-based study","volume":"23","author":"Moon","year":"2018","journal-title":"Respirology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1093\/ejcts\/ezx357","article-title":"Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy","volume":"53","author":"Nomori","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.1016\/j.jtcvs.2011.09.028","article-title":"Video-assisted thoracoscopic surgery (VATS) lobectomy: catastrophic intraoperative complications","volume":"142","author":"Flores","year":"2011","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1093\/ejcts\/ezv287","article-title":"Major intraoperative complications during video-assisted thoracoscopic anatomical lung resections: an intention-to-treat analysis","volume":"48","author":"Decaluwe","year":"2015","journal-title":"Eur J Cardiothorac Surg"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23979","article-title":"Lingular division of the left lung: only superior and inferior bronchi?","author":"Zhang","year":"2022","journal-title":"Clin Anat"},{"key":"B9","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1007\/s00595-022-02471-1","article-title":"Pulmonary vessels and bronchus anatomy of the left upper lobe","volume":"52","author":"Maki","year":"2022","journal-title":"Surg Today"},{"key":"B10","doi-asserted-by":"publisher","first-page":"305","DOI":"10.21037\/atm-22-598","article-title":"Anatomical analysis of variations in the bronchus pattern of the left upper lobe using three-dimensional computed tomography angiography and bronchography","volume":"10","author":"He","year":"2022","journal-title":"Ann Transl Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"5035","DOI":"10.21037\/jtd-21-1141","article-title":"Analysis of anatomical variations of the lingular artery of the left upper lobe using 3D computed tomography angiography and bronchography","volume":"13","author":"He","year":"2021","journal-title":"J Thorac Dis"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1028467","DOI":"10.3389\/fonc.2022.1028467","article-title":"Anatomical variation analysis of left upper pulmonary blood vessels and bronchi based on three-dimensional reconstruction of chest CT","volume":"12","author":"Deng","year":"2022","journal-title":"Front Oncol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1186\/s13019-021-01682-w","article-title":"Analysis of bronchial and vascular patterns in left upper lobes to explore the genesis of mediastinal lingular artery and its influence on pulmonary anatomical variation","volume":"16","author":"Gao","year":"2021","journal-title":"J Cardiothorac Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1186\/s13019-020-01323-8","article-title":"Anatomical analysis of the left upper lobe of lung on three-dimensional images with focusing the branching pattern of the subsegmental veins","volume":"15","author":"Isaka","year":"2020","journal-title":"J Cardiothorac Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1007\/s11604-020-01024-1","article-title":"An analysis of anatomical variations of the left pulmonary artery of the interlobar portion for lung resection by three-dimensional CT pulmonary angiography and thin-section images","volume":"38","author":"Murota","year":"2020","journal-title":"Jpn J Radiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1273","DOI":"10.1038\/s41598-017-01384-1","article-title":"Mediastinal pulmonary artery is associated with greater artery diameter and lingular division volume","volume":"7","author":"Dejima","year":"2017","journal-title":"Sci Rep"},{"key":"B17","doi-asserted-by":"publisher","first-page":"5933","DOI":"10.21037\/jtd-21-985","article-title":"A modified system for classifying the bilateral superior pulmonary veins using three-dimensional computed tomography bronchography and angiography images","volume":"13","author":"Wang","year":"2021","journal-title":"J Thorac Dis"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1016\/j.athoracsur.2019.05.020","article-title":"Incidence, management, and outcomes of intraoperative catastrophes during robotic pulmonary resection","volume":"108","author":"Cao","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"52","DOI":"10.21037\/jovs.2017.02.05","article-title":"Catastrophes and complicated intraoperative events during robotic lung resection","volume":"3","author":"Louie","year":"2017","journal-title":"J Vis Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.athoracsur.2016.02.004","article-title":"Incidence, results, and our current intraoperative technique to control Major vascular injuries during minimally invasive robotic thoracic surgery","volume":"102","author":"Cerfolio","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.ejcts.2008.07.014","article-title":"Preoperative assessment of the pulmonary artery by three-dimensional computed tomography before video-assisted thoracic surgery lobectomy","volume":"34","author":"Fukuhara","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"388","DOI":"10.5603\/FM.a2016.0081","article-title":"Three-dimensional computed tomography angiography of the pulmonary veins and their anatomical variations: involvement in video-assisted thoracoscopic surgery-lobectomy for lung cancer","volume":"76","author":"Fourdrain","year":"2017","journal-title":"Folia Morphol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1510\/icvts.2009.221804","article-title":"Importance of preoperative assessment of pulmonary venous anomaly for safe video-assisted lobectomy","volume":"10","author":"Yamada","year":"2010","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1093\/icvts\/ivw030","article-title":"Do the lung segments exist continuously from the early stage of the embryonic period as units?","volume":"23","author":"Onuki","year":"2016","journal-title":"Interact Cardiovasc Thorac Surg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1173602\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T22:29:10Z","timestamp":1682029750000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1173602\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,20]]},"references-count":24,"alternative-id":["10.3389\/fsurg.2023.1173602"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2023.1173602","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,20]]},"article-number":"1173602"}}