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Three-dimensional imaging for thoracoscopic resection of complex lung anomalies.

Surgical Case Reports 2017 September 26
BACKGROUND: Building surgical strategies for complex lung anomalies such as congenital pulmonary venolobar syndrome is difficult because of their rarity and variance. Using three-dimensional computed tomography (3D-CT), we can determine strategies safely. We describe a 27-year-old man with multifocal pulmonary malformations who underwent video-assisted thoracoscopic surgery (VATS) using 3D-CT.

CASE PRESENTATION: A 27-year-old man presented with hemoptysis associated with complex pulmonary malformations, including a triple-arched vein connecting the superior and inferior pulmonary veins with partial drainage into the inferior vena cava, a systemic and numerous arterial supply to the right lower lobe from the abdominal aorta, abnormal lobulation, and a tracheal bronchus in the right lung. Preoperative simulation using 3D-CT helped to determine the optimal surgical strategy, allowing for successful and safe completion of semi-emergent middle and lower bilobectomy via minimally invasive VATS.

CONCLUSIONS: Preoperative simulation using 3D-CT helped to determine the optimal surgical strategy, allowing for successful and safe completion of surgery even in a complex case.

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