Variation of right B2 downwards-shift:A special type of tracheal bronchus
Objective To analyze and summarize the changes of the bronchus and vessels of right B2 downwards-shift.Methods The 5 280 patients who underwent three-dimensional computed tomography bronchography and angiography between January 2019 and January 2022 were screened.Based on the opening position of B1+3,we classified bronchial variations into a normal type,over type,and tracheal-bronchus type.Results Finally 6 patients were included with 1 male and 5 females,aged 29 to 71 years.According to our bronchial classification,there were 4(66.7％)patients of the normal type in this group,1(16.7％)of over type,and 1(16.7％)of tracheal-bronchus type.About arteries,4(66.7％)patients was the trunk superior(Tr.sup)+posterior artery(A.post)type and 2(33.3％)Tr.sup+trunk inferior(Tr.inf)+A.post type.About veins,2(33.3％)patients were the Ⅰ ab+right upper lobe vein posterior to the bronchus intermedius(UVPBI)type,1(16.7％)Ⅰ b+UVPBI type,1(16.7％)anterior+UVPBI type,1(16.7％)central+UVPBI type and 1(16.7％)central type.Conclusion In the right B2 downwards-shift,A.post exists,and the posterior oblique fissure is poorly developed(RS2 and RS6 are interconnected).Therefore,it is easier for us to dissect and disconnect B2 intraoperatively,but it is necessary to be vigilant for vascular damage caused by opening the posterior oblique fissure.
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