En Bloc Upper and Lower Lobe Trisegmentectomy Facilitated by Displaced Segmental Airway.

A 66-year-old woman was referred to our hospital. Computed tomography revealed a partly solid ground-glass nodule located in the left S1+2 and spread over the left S6 . Pathologic diagnosis was primary adenocarcinoma (c-T2a N0 M0 c-stage IB). The left B1+2 arose from the left main bronchus and was displaced superiorly behind the left main pulmonary artery. Severely incomplete lobulation was also recognized. We performed trisegmentectomy, and negative margins were confirmed. The patient is now asymptomatic without recurrence. It is very important to grasp the anatomical structure and consider the surgical procedure preoperatively by making full use of computed tomography and bronchoscopy.