Objective To investigate the anatomical characteristics of the right top pulmonary vein(RTPV),a rare variant pulmonary vein displayed on chest CT,and its clinical significance in thoracoscopic right lung surgery.Methods The clinical data from 27 patients who underwent thoracoscopic right lung surgery were collected.Of these,24 patients were diagnosed with RTPV by preoperative chest CT.The anatomical characteristics were analyzed in combination with three-dimensional reconstruction.Three cases were diagnosed with RTPV based on preoperative chest CT after abnormal veins behind the intermediate bronchus were identified during surgery.Results Of the 27 patients of RTPV,22 cases drained blood from the posterior segment of the right upper lobe(S2),4 cases drained blood from both the S2 and S6a,and 1 case drained blood from both the S2 and S1a.After crossing behind the intermediate bronchus,13 cases returned blood to the lower pulmonary vein,5 cases returned blood to V6,7 cases returned blood to the left atrium,and 2 cases returned blood to the root of the upper pulmonary vein.The vascular diameter of the RTPV was(5.1±1.7)mm.All 27 patients successfully completed thoracoscopic surgery without massive hemorrhage caused by accidental injury to the PTRV.The intraoperative anatomy corresponded to the preoperative chest CT and three-dimensional reconstruction.The intraoperative bleeding volume was(44.6±43.7)mL,and there was no massive hemorrhage caused by accidental injury to the RTPV.Nine patients underwent right lower lobectomy,and four patients had the RTPV preserved,with no postoperative hemoptysis.Five patients underwent RTPV transection,of which two experienced transient hemoptysis following surgery with no serious complications.Conclusion Chest thin-section CT can be applied to diagnose RTPV.Preoperative identification via CT is crucial to avoid massive hemorrhage resulting from accidental injury during thoracoscopic surgery of the right lung.RTPV can be preserved as appropriate in patients undergoing right lower lobectomy.

Objective To investigate the anatomical characteristics of the right top pulmonary vein(RTPV),a rare variant pulmonary vein displayed on chest CT,and its clinical significance in thoracoscopic right lung surgery.Methods The clinical data from 27 patients who underwent thoracoscopic right lung surgery were collected.Of these,24 patients were diagnosed with RTPV by preoperative chest CT.The anatomical characteristics were analyzed in combination with three-dimensional reconstruction.Three cases were diagnosed with RTPV based on preoperative chest CT after abnormal veins behind the intermediate bronchus were identified during surgery.Results Of the 27 patients of RTPV,22 cases drained blood from the posterior segment of the right upper lobe(S2),4 cases drained blood from both the S2 and S6a,and 1 case drained blood from both the S2 and S1a.After crossing behind the intermediate bronchus,13 cases returned blood to the lower pulmonary vein,5 cases returned blood to V6,7 cases returned blood to the left atrium,and 2 cases returned blood to the root of the upper pulmonary vein.The vascular diameter of the RTPV was(5.1±1.7)mm.All 27 patients successfully completed thoracoscopic surgery without massive hemorrhage caused by accidental injury to the PTRV.The intraoperative anatomy corresponded to the preoperative chest CT and three-dimensional reconstruction.The intraoperative bleeding volume was(44.6±43.7)mL,and there was no massive hemorrhage caused by accidental injury to the RTPV.Nine patients underwent right lower lobectomy,and four patients had the RTPV preserved,with no postoperative hemoptysis.Five patients underwent RTPV transection,of which two experienced transient hemoptysis following surgery with no serious complications.Conclusion Chest thin-section CT can be applied to diagnose RTPV.Preoperative identification via CT is crucial to avoid massive hemorrhage resulting from accidental injury during thoracoscopic surgery of the right lung.RTPV can be preserved as appropriate in patients undergoing right lower lobectomy.