Anomalous bronchus and pulmonary artery in a patient who underwent subsegmentectomy of right S6a + b.

This report describes the case of a woman with small-sized peripheral lung cancer who underwent thoracoscopic right superior subsegmentectomy of S6a + b. Preoperative multiplanar reconstruction computed tomography revealed an anomalous posterior basal bronchus (B10c) and pulmonary artery (A10c), branching from the right lower superior segment bronchus (B6) and artery (A6), respectively. A three-dimensional (3D) model of the bronchi and pulmonary vessels and virtual bronchoscopy images were created to confirm the anomalous bronchus and pulmonary artery. Right superior subsegmentectomy of the right S6a + b was performed with the preservation of the anomalous posterior basal bronchus and pulmonary artery, as planned preoperatively, with no intraoperative or postoperative complications. The preoperative 3D reconstruction image was useful for understanding the patient's anatomy. Furthermore, an understanding of anatomy is necessary when performing segmentectomy in patients with anomalous bifurcations of the pulmonary artery and bronchus.