Shteyner Mikhail L'vovich, Doctor of medical sciences, endoscopist of the endoscope office, Samara City Hospital No. 4 (125, Michurina street, Samara, Russia); associate professor, sub-department of surgery with a course of endoscopy of the Institute of Vocational Education, Samara State Medical University (89, Chapayevskaya street, Samara, Russia), E-mail: email@example.com
Background. The paper is devoted to certain issues of the tracheobronchial tree endoscopic anatomy and in particular to anatomical features of left lung lower lobe, which bronchoscopists often encounter.
Materials and methods. The results of 5474 primary bronchoscopies (100.00 %) were studied. When evaluating the endobronchial picture, we used the tracheobronchial tree systematics according to the generally accepted classification of the lungs segmental structure by Oho K.-Amemiya R. (1984). Non-parametric McNemar test was used for the statistical assessment of the revealed anomalies of the left lung lower lobe bronchial branching frequency compared to the respective frequency in the right lower lobe, as well as for the assessment of anatomical shape features of the left lung lower lobe segmental bronchi.
Results. In the left basal pyramid, the spindle-shaped form of bronchus B9 is noted in 0.86 % cases. On the right, this anatomical version has never occured. We also propose a method for differential diagnosis of the left bronchus B9 spindle-shaped form as a variant of the anatomical norm or as bronchus deformation reflecting pathological changes. We establish a statistically significant increase in the number of the basal pyramid additional bronchial tubes and “separate” B6a bronchus on the left (5.10 % and 0.68 %, respectively), compared to similar changes in the right lung lower lobe (0.42 % and 0.05 %). Differences in the frequency of additional cardiac bronchi detection did not reach the level of statistical significance.
Conclusions. Additional left lung lower lobe endoscopic anatomy features (except for previously known absence of segmental bronchus B7) include: the frequent spindle-shaped form of segmental bronchus B9, a statistically significant increase in the incidence of the left lung lower lobe additional bronchi in the basal pyramid region and the “separate” bronchus B6a.
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