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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_839_Библиотеки_им_академика_М_И_Перельмана
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xiv
Editors and Contributors
DaWu Chief Surgeon, is the Consultant of Thoracic Surgery
Department in Peking University Shenzhen Hospital.
In 1986, he graduated from the Medical Department of
Baiqiu’en Medical University with a master’s degree.
He studied in the Department of Thoracic Surgery at the
Cancer Hospital of the Chinese Academy of Medical Sciences
under Professor Dechao Zhang and Professor Shugeng Gao in
1997 and in the Department of Respiratory Surgery at Tokyo
Cancer Research Ariake Hospital under Prof. Ken Nakagawa in
2004.
Academic position:
Director of the Thoracic Surgery Committee of Shenzhen
Medical Association;
Vice President of the Association of Thoracic Surgeons of
Shenzhen.
Specialties:
Dr. Wu has engaged in clinical work in thoracic surgery for
more than 30 years and has deep insight on early screening of
lung cancer (especially on lung nodules) and specializes in the
diagnosis and surgical treatment of lung cancer, esophageal
cancer, mediastinal and chest wall tumors. He has also undertaken many research projects and published more than 50
articles.
Drawing
JunbinWang graduated from Shantou University in 2014. He
practices all aspects of thoracic surgery under Professor Jixian
Liu in Peking University Shenzhen Hospital, performing minimally invasive surgery of the lung, esophagus, mediastinum,
and diaphragm, and specializes in the comprehensive diagnosis
and treatment of lung cancer, esophageal cancer, mediastinal
diseases, complex pneumothorax, pulmonary nodules and
masses, palmar hyperhidrosis, etc.
Painting is his hobby. He nds it fascinating to link painting
with medicine.
Editors and Contributors
xv
English Review
SuenHonChi graduated from the University of Hong Kong in
1982. After local training in cardiothoracic surgery in Hong
Kong, he pursued further training at Harvard University (under
Dr. Hermes Grillo) and Washington University in St. Louis
(under Drs. Joel Cooper and Alexander Patterson). He then
practiced in St. Louis for 20 years before returning to Hong
Kong in 2019. Dr. Suen practices all aspects of cardiothoracic
surgery, performing the most minimally invasive to the most
maximally aggressive surgery of the heart, lung, esophagus,
mediastinum, and diaphragm. In 2021, he was appointed
Honorary Clinical Associate Professor at the Department of
Surgery of the Chinese University of Hong Kong.
AndrewC.Chang, M.D. , is the John Alexander Distinguished
Professor, Head of the Section of Thoracic Surgery at the
University of Michigan. After completing his undergraduate
education at the Massachusetts Institute of Technology and
medical education at Johns Hopkins University, he pursued
general surgical residency at Vanderbilt University. He received
an individual National Research Service Award from the
National Institutes of Health to study cardiothoracic transplantation with Richard N.Pierson, III, M.D.He continued as a thoracic surgical resident and thoracic surgical fellow at the
University of Michigan where he then joined the faculty in the
Department of Surgery. Dr. Chang’s clinical interests include
thoracic oncology, esophageal diseases, pulmonary transplantation, minimally invasive surgery, and interventional
endoscopy.
Jingjing(May) Liu graduated from Vanderbilt University in
2021 concentrating on Psychology and Computer Science studies. She is a Software Engineer in Microsoft.
xvi
Associate Editors
Guangxian Mao Department of Thoracic Surgery, Peking University Shenzhen Hospital,
Shenzhen, Guangdong, China
Junbin Wang Department of Thoracic Surgery, Peking University Shenzhen Hospital,
Shenzhen, Guangdong, China
Yuancai Xie Department of Thoracic Surgery, Peking University Shenzhen Hospital,
Shenzhen, Guangdong, China
Contributors
JixianLiu Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen,
Guangdong, China
SongtaoLiu Zhenyuan (Tianjin) Medical Device Technology Co., Tianjin, China
Xiaoqiang Li Department of Thoracic Surgery, Peking University Shenzhen Hospital,
Shenzhen, Guangdong, China
Feihu Long Department of Thoracic Surgery, Peking University Shenzhen Hospital,
Shenzhen, Guangdong, China
Editors and Contributors
Xinyu Luan Department of Thoracic Surgery, Peking University Shenzhen Hospital,
Shenzhen, Guangdong, China
DanMa Johnson & Johnson Medical Shanghai Ltd., Shanghai, China
Xuxing Peng Department of Thoracic Surgery, Peking University Shenzhen Hospital,
Shenzhen, Guangdong, China
HeWang Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen,
Guangdong, China
Zichun Wei Department of Thoracic Surgery, Peking University Shenzhen Hospital,
Shenzhen, Guangdong, China
DaWu Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen,
Guangdong, China
LeiYang Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen,
Guangdong, China
YiwangYe Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen,
Guangdong, China
WeiYue Department of Thoracic Surgery, Peking University Shenzhen Hospital, Shenzhen,
Guangdong, China
A Brief History ofThoracoscopic
Anatomical Segmentectomy by 3D
Navigation
JixianLiu andGuangxianMao
1
The concept of “Bronchopulmonary Segmental Anatomy”
was rst introduced by Ewart in England in 1889. In 1932,
Kramer and Glass applied the concept to the clinical setting
for the rst time during their studies in pulmonary abscesses.
In 1939, Churchill and Belsev performed the rst case of
Lingular Segmentectomy. In 1942, Kent and Blades proposed the technique of “Separate Treatment to Hilar
Structures,” known as the early form of “Anatomical
Segmentectomy.” In 1958, Church et al. began to use the
technique of “Anatomical Segmentectomy” to treat earlystage lung cancer. In 1993, the rst Thoracoscopic
Segmentectomy was conducted by Roviaro in Italy.
In the past, segmentectomy was not a popular technique
due to complicated anatomical variants, exquisite technical
requirements, and overmuch postoperative air leakage. In the
twenty-rst century, with rapid development of thoracoscopic techniques and an increasing number of patients diagnosed with early lung cancer, more clinical applications of
segmentectomy have taken place. In 2011, Illustrated
Anatomical Segmentectomy for Lung Cancer edited by Dr.
Hiroaki Nomori and Morihito Okada from Japan have systematically summarized the anatomical features and surgical
essences of segmentectomy, promoting the development of
segmentectomy all over the world.
Emerging reconstruction software, such as MIMICS, in
segmentectomy empowers surgeons to easily navigate individualized segmental anatomy more precisely prior to operations. In the past 10 years, Dr. Chen Liang and his team in
Jiangsu Province People’s Hospital have independently
developed a software named DeepInsight. They have con-
ducted in-depth research and practice on 3D-Computed
Tomography, Bronchography, and Angiography (3D-CTBA)
and anatomic segmentectomy guided by 3D-CTBA. The
team later summarized their practices in the book The Atlas
of Thoracoscopic Anatomical Pulmonary Segmentectomy,
which has been reprinted for the 4th edition. Their work has
promoted the development of segmentectomy techniques in
China. Dr. Chen Tsun’s team at Union Hospital of Fujian
Medical University, Dr. Bin Qiu’s team at Cancer Hospital of
the Chinese Academy of Medical Sciences, Dr. Yongfu Ma at
PLA General Hospital, and Dr. Jixian Liu at Peking
University Shenzhen Hospital have held several seminars on
Standard Segmentectomy by 3D navigation. All efforts have
promoted a wider use of segmentectomy in China.
Suggested Reading
1. Andol M, Potenza R, Capozzi R, Liparulo V, Puma F, Yasufuku
K.The role of bronchoscopy in the diagnosis of early lung cancer: a
review. J Thorac Dis. 2016;8:3329–37.
2. Refai M, Andol M, Gentili P, Pelusi G, Manzotti F, Sabbatini
A. Enhanced recovery after thoracic surgery: patient information
and care plans. J Thorac Dis. 2018;10:S512–6.
3. Ginsberg RG, Rubinstein LV.Randomized trial of lobectomy versus
limited resection for T1N0 non-small cell lung cancer. Lung cancer
study group. Ann Thorac Surg. 1995;60:615–22.
4. Cao C, D’Amico T, Demmy T, Dunning J, Gossot D, Hansen H,
etal. Less is more: a shift in the surgical approach to non-small-cell
lung cancer. Lancet Respir Med. 2016;4:e11–2.
5. Schuchert M, Pettiford B, Keeley S, D’Amato T, Kilic A, Close J,
etal. Anatomic segmentectomy in the treatment of stage I non-small
cell lung cancer. Ann Thorac Surg. 2007;84:926–33.
J. Liu (*) · G. Mao
Department of Thoracic Surgery, Peking University Shenzhen
Hospital, Shenzhen, Guangdong, China
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023
J. Liu, D. Wu (eds.), Segmentectomy for Early-Stage Lung Cancer, https://doi.org/10.1007/978-981-99-0143-2_1
1
Nomenclature ofSegments
JixianLiu andJunbinWang
2
2.1 Section 1: Nomenclature
ofSegmental andSubsegmental
Lung
2.1.1 Right Upper Lobe (Fig.2.1)
1. S1 [Segmentum.apicale]
(a) S1a [Subsegmentum.apicale proprius]
(b) S1b [Subseg.ventrale]
2. S2 [S.dorsale]
(a) S2a [Subseg.dorsale]
(b) S2b [Subseg.horizontale]
3. S3 [S.ventrale]
(a) S3a [Subseg.laterale]
(b) S3b [Subseg.mediale]
2.1.2 Right Middle Lobe (Fig.2.1)
1. S4 [S.medium laterale]
(a) S4a [Subseg.laterale]
(b) S4b [Subseg.mediale]
2. S5 [S.medium mediale]
(a) S5a [Subseg.laterale]
(b) S5b [Subseg.mediale]
2.1.3 Left Upper Lobe (Fig.2.1)
1+2
1. S
(a) S
(b) S
(c) S
[S.apicodorsale]
1+2
a [Subseg.apicale]
1+2
b [Subseg.dorsale]
1+2
c [Subseg.horizontale]
2. S3 [S.ventrale]
(a) S3a [Subseg.laterale]
(b) S3b [Subseg.mediale]
(c) S3c [Subseg.superius]
3. Lingular Division (S4+S5)
(a) S4 [S.lingulare superius]
(i) S4a [Subseg.laterale]
(ii) S4b [Subseg.mediale]
(b) S5 [S.lingulare inferius]
(i) S5a [Subseg.superius]
(ii) S5b [Subseg.inferius]
2.1.4 Lower Lobe (Fig.2.1)
1. S6 [S.superius]
(a) S6a [Subseg.superius]
(b) S6b [Subseg.laterale]
(c) S6c [Subseg.mediale]
2. S* [S.subsuperius]
3. S7 [S.mediobasale] (only right side)
(a) S7a [Subseg.dorsale]
(b) S7b [Subseg.ventrale]
4. S8 [S.ventrobasale]
(a) S8a [Subseg.laterale]
(b) S8b [Subseg.basale]
5. S9 [S.laterobasale]
(a) S9a [Subseg.laterale]
(b) S9b [Subseg.basale]
6. S10 [S.dorsobasale]
(a) S10a [Subseg.dorsale]
(b) S10b [Subseg.laterale]
(c) S10c [Subseg.mediale]
J. Liu (*) · J. Wang
Department of Thoracic Surgery, Peking University Shenzhen
Hospital, Shenzhen, Guangdong, China
© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023
J. Liu, D. Wu (eds.), Segmentectomy for Early-Stage Lung Cancer, https://doi.org/10.1007/978-981-99-0143-2_2
3
4
Fig. 2.1 Anatomical
subdivisions of lung segments
(courtesy of Bin Qiu)
J. Liu and J. Wang
2.2 Section 2: Nomenclature
ofSegmental andSubsegmental
Bronchus
2.2.1 Right Upper Lobe (Fig.2.2)
1. B1 [R.apicalis]
(a) B1a [Rm.apicalis proprius]
(b) B1b [Rm.ventralis]
2. B2 [R.dorsalis]
(a) B2a [Rm.dorsalis]
(b) B2b [Rm.horizontalis]
3. B3 [R.ventralis]
(a) B3a [Rm.latelasis]
(b) B3b [Rm.medialis]
2.2.2 Right Middle Lobe (Fig.2.2)
1. B4 [R.medius lateralis]
(a) B4a [Rm.lateralis]
(b) B4b [Rm.medialis]
right lung left lung
2. B5 [R.medius medialis]
(a) B5a [Rm.lateralis]
(b) B5b [Rm.medialis]
2.2.3 Left Upper Lobe (Fig.2.2)
1+2
1. B
(a) B
(b) B
(c) B
2. B3 [R.ventralis]
(a) B3a [Rm.lateralis]
(b) B3b [Rm.medialis]
(c) B3c [Rm.superius]
3. B4 [R.lingualis superius]
(a) B4a [Rm.lateralis]
(b) B4b [Rm.medialis]
4. B5 [R.lingualis inferius]
(a) B5a [Rm.superius]
(b) B5b [Rm.inferius]
[R.apicodorsalis]
1+2
a [Rm.apicalis]
1+2
b [Rm.dorsalis]
1+2
c [Rm.horizontalis]
2 Nomenclature ofSegments
Fig. 2.2 Lung subsegmental
bronchi (courtesy of Junbin
Wang)
5
1a
1b
B
B
2a
B
2b
B
B
B
10b
3
B
3b
B
4
6b
B
B
5
B
5b
8
B
8a
8b
B
9
B
10a
B
3a
B
4a
B
4b
B
5a
B
B
9a
B
B
1
B
2
6a
B
6c
B
7
B
7a
B
7b
B
10
B
10c
B
10b
B
B
10a
1+2b
B
B
B
6c
B
10
B
10c
B
1+2
6a
B
10b
B
B
B
B
B
3c
B
B3B
5
6b
7+8
9
B
1+2a
9b
B
B
4
B
7+8b
5b
1+2c
B
B
5a
7+8a
B
3c
B
3b
B
4a
B
4b
B
9a
2.2.4 Lower Lobe (Fig.2.2)
1. B6 [R.superius]
(a) B6a [Rm.superius]
(b) B6b [Rm.lateralis]
(c) B6c [Rm.medialis]
2. B* [R.subsuperius]
3. B7 [R.mediobasalis] (only right side)
(a) B7a [Rm.dorsalis]
(b) B7b [Rm.ventralis]
4. B8 [R.ventrobasalis]
(a) B8a [Rm.lateralis]
(b) B8b [Rm.basalis]
5. B9 [R.laterobasalis]
(a) B9a [Rm.lateralis]
(b) B9b [Rm.basalis]
6. B10 [R.dorsobasalis]
(a) B10a [Rm.dorsalis]
(b) B10b [Rm.lateralis]
(c) B10c [Rm.medialis]
2.3 Section 3: Nomenclature
ofSegmental andSubsegmental
Artery
2.3.1 Right Upper Lobe (Fig.2.3)
1. A1 [R.apicalis]
(a) A1a [Rm.apicalis proprius]
(b) A1b [Rm.ventralis]
2. A2 [R.dorsalis]
(a) A2a [Rm.dorsalis]
(b) A2b [Rm.horizontalis]
3. A3 [R.ventralis]
(a) A3a [Rm.latelasis]
(b) A3b [Rm.medialis]
2.3.2 Right Middle Lobe (Fig.2.3)
1. A4 [R.medius lateralis]
(a) A4a [Rm.lateralis]
(b) A4b [Rm.medialis]
2. A5 [R.medius medialis]
(a) A5a [Rm.lateralis]
(b) A5b [Rm.medialis]
2.3.3 Left Upper Lobe (Fig.2.4)
1+2
1. A
(a) A
(b) A
(c) A
2. A3 [R.ventralis]
(a) A3a [Rm.lateralis]
(b) A3b [Rm.medialis]
(c) A3c [Rm.superius]
3. A4 [R.lingualis superius]
(a) A4a [Rm.lateralis]
(b) A4b [Rm.medialis]
[R.apicodorsalis]
1+2
a [Rm.apicalis]
1+2
b [Rm.dorsalis]
1+2
c [Rm.horizontalis]
6
J. Liu and J. Wang
4. A5 [R.lingualis inferius]
(a) A5a [Rm.superius]
(b) A5b [Rm.inferius]
2.3.4 Lower Lobes (Figs.2.3 and2.4)
1. A6 [R.superior]
(a) A6a [Rm.superius]
(b) A6b [Rm.lateralis]
(c) A6c [Rm.medialis]
2. A* [R.subsuperius]
3. A7 [R.mediobasalis] (only right side)
(a) A7a [Rm.dorsalis]
(b) A7b [Rm.ventralis]
4. A8 [R.ventrobasalis]
(a) A8a [Rm.lateralis]
(b) A8b [Rm.basalis]
5. A9 [R.laterobasalis]
(a) A9a [Rm.lateralis]
(b) A9b [Rm.basalis]
6. A10 [R.dorsobasalis]
(a) A10a [Rm.dorsalis]
(b) A10b [Rm.lateralis]
(c) A10c [Rm.medialis]
Fig. 2.4 Left lung artery branchesFig. 2.3 Right lung artery branches
2 Nomenclature ofSegments
Fig. 2.5 Vein branches of
right upper lobe (Red for
arteries; Green for bronchi;
Blue for veins)
7
2.4 Section 4: Nomenclature
ofSegmental andSubsegmental Vein
2.4.1 Right Upper Lobe (Fig.2.5)
1. V1 (V.apicalis)
(a) V1a: between S1a and S1b
(b) V1b: between S1b and S3b
2. V2 (V.dorsalis)
(a) V2a: between S1a and S2a
(b) V2b: between S2a and S2b
(c) V2c: between S2b and S3a
(d) V2t: below S2a
3. V3 (V. ventralis)
(a) V3a: between S3a and S3b
(b) V3b: below S3b
(c) V3c between S3bi and S3bii
4. Central vein: V2a+V2b+V2c (+V3a)
2.4.2 Right Middle Lobe (Fig.2.6)
1. V4 (V.media.lateralis)
(a) V4a: between S4a and S4b
(b) V4b: between S4b and S5b
2. V5 (V.media.medialis)
(a) V5a: between S5a and S5b
(b) V5b: below S5b
2.4.3 Left Upper Lobe (Figs.2.7 and2.8)
1+2
1. V
(a) V
(b) V
(c) V
(d) V
2. V3 (V.ventralis)
(a) V3a: between S3a and S3b
(b) V3b: between S3b and S4b
(c) V3c: between S3b and S3c
3. V4 (V.lingualis superius)
(a) V4a:between S4a and S4b
(b) V4b: between S4b and S5a
4. V5 (V.lingualis inferius)
(a) V5a: between S5a and S5b
(b) V5b: below S5b
(V.apicodorsalis)
1+2
a: between S
1+2
b: between S
1+2
c: between S
1+2
d: between S
1+2
a and S3c
1+2
a and S
1+2
b and S
1+2
c and S3a
1+2
1+2
b
c
8
Fig. 2.6 Venous branches of
right middle lobe (Red for
arteries; Green for bronchi;
Blue for veins)
J. Liu and J. Wang
Fig. 2.7 Veins branches of
proper lobe in left upper lobe
(Red for arteries; Green for
bronchi; Blue for veins)
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