Impact of Right Top Pulmonary Vein Location on Subcarinal Lymph Node Dissection in Thoracoscopic Esophagectomy: A Case Report and Literature Review

• DOI: 10.70352/scrj.cr.24-0093
• Publication Date: 2025-02-27T22:19:17Z
• Authors: Takeshi Horaguchi; Yuta Sato; Yuji Hatanaka; Yoshihiro Tanaka; Noriki Mitsui; Masahiro Fukada; Itaru Yasufuku; Ryuichi Asai; Jesse Yu Tajima; Nobuhisa Matsuhashi
• Keywords: Esophagectomy

The right top pulmonary vein (RTPV) is a rare anatomical variant that arises independently of the superior lobe. It drains behind main bronchus or intermedius and into left atrium another vein. This anomaly poses challenges during subcarinal lymph node dissection in thoracic surgery, such as esophagectomy, owing to risk vascular injury. RTPV mainly located intermediate bronchus; however, reports focusing on these sites are lacking. Herein, we present case esophageal cancer with an was treated thoracoscopic esophagectomy propose convenient classification for findings site. A 71-year-old man underwent (T1bN0M0) routine medical checkup. preoperative computed tomography scan revealed which drained bronchus. Radical lymphadenectomy performed while preserving RTPV, using 3 dimensions simulation intraoperative navigation. operation lasted 6 h 42 min, blood loss volume 30 mL. patient's postoperative course uneventful, he discharged day 21. In retrospective review surgery cases at our hospital, observed 17/314 (5.4%). most common inflow site inferior (IPV) (9 cases), followed by (5 (2 branch IPV (1 case). 4 13 cases, respectively. Compared past reviews, varied somewhat; location remained same. By classifying areas bronchi Zones 1 2, respectively, runs through Zone 1, identified tomography, should be manipulated caution due injury beneath tracheal bifurcation.