title: Analysis of the variation pattern in right upper pulmonary veins and establishment of simplified vein models for anatomical segmentectomy.
abstract: OBJECTIVE
  Thoracic surgeons must be erudite pulmonary vein variation when performing anatomical segmentectomy. We used three-dimensional CT (3DCT) to accumulate variations of the pulmonary veins of the right upper lobe (RUL) and created a simplified RUL vein model.
  
  
  METHODS
  We reviewed anatomical variations of the RUL pulmonary veins of 338 patients using 3DCT images, and classified them by position related with bronchus.
  
  
  RESULTS
  Of the "anterior" and "central" RUL veins, all could be classified into 4 types: 2 Anterior with Central types (Iab and Ib), 1 Anterior type, and 1 Central type. The Anterior with Central type was observed in 273 patients (81 %), and was further classified into two types according to the origin of the anterior vein. In the Iab type, the anterior vein originated from V1a to V1b (54 %) whereas, in the Ib type, the anterior vein originated from only V1b (26 %). The Central type, which had no anterior vein, was evident in 23 cases (7 %). These three types could be further divided into three subcategories by reference to the branching pattern of the central vein. The Anterior type, which had no central vein, was evident in 42 cases (12 %), and this type could be further categorized into two types, depending on the branching pattern of the anterior vein.
  
  
  CONCLUSIONS
  We created a simplified RUL vein model to facilitate anatomical segmentectomy. Our models should find wide application, especially when thoracic surgery requiring anatomical RUL segmentectomy is planned.
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan. kmshimizu@gmail.com.|Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan. kmshimizu@gmail.com.
authors.forename: Kimihiro
authors.identifier: http://orcid.org/0000-0003-4076-5174
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.|Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Toshiteru
authors.initials: T
authors.lastname: Nagashima
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.|Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Ohtaki
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.|Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Kai
authors.initials: K
authors.lastname: Obayashi
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.|Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Seshiru
authors.initials: S
authors.lastname: Nakazawa
authors.affiliation: Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.|Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma, 371-0014, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Kamiyoshihara
authors.affiliation: Department of General Thoracic Surgery, Maebashi Red Cross Hospital, 3-21-36 Asahi-cho, Maebashi, Gunma, 371-0014, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Igai
authors.affiliation: Department of Thoracic and Visceral Organ Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Takeyoshi
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Mogi
authors.affiliation: Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008168:Lung / Q000098:blood supply / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D011013:Pneumonectomy / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D011667:Pulmonary Veins / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Pulmonary vein; Right upper lobe; Segmentectomy; Three-dimensional computed tomography