肺癌に対する右肺S6＋S＊区域切除

Thoracoscopic Superior and Subsuperior Segmentectomy of the Right Lower Lung for Lung Cancer

右肺下葉区域気管支の過剰分岐として，上下葉区（S6）と後肺底区（S10）の間に分岐する上枝下-下葉枝（B＊）があることが知られている．B＊により上枝下-下葉区（S＊）が形成されるが，われわれは右肺S6＋S＊区域切除術を行った症例を経験したので報告する．

The subsuperior segment （S＊） is not frequently observed between the superior （S6） and posterior basal segments （S10）. We present a case of video-assisted thoracoscopic surgery of S6＋S＊ segmentectomy for a primary lung cancer patient. A 71-year-old man with a 20-mm nodule on the right S6, suspected of primary lung cancer （cT1bN0M0, stageⅠA2）, was admitted to our hospital. Three-dimensional chest computed tomography （CT） revealed a subsuperior segmental bronchus （B＊）, originating from the common trunk of the lateral basal segmental bronchus （B9） and posterior basal segmental bronchus （B10）. In order to obtain enough surgical margin, we performed S6＋S＊ segmentectomy. The pathological diagnosis was invasive adenocarcinoma （pT1cN0M0, stageⅠA3）. S＊ segmentectomy was considered to be useful method to ensure sufficient surgical margin when the lesion is in S＊ or in segments adjacent to it.