A 67-year-old woman, with multimorbidity and previously treated squamous cell carcinoma of the tongue, was admitted to the author's clinic for the treatment of a 1.1 cm squamous cell carcinoma located in the posterior segment of the left upper lobe. A single incision of 3 – 3.5 cm was made in the fifth intercostal space posteriorly, in the so-called "triangle of auscultation." A nonanatomical posterior segment resection of the upper left lobe was conducted (the segment vein was ignored), followed by lymphadenectomy.
However, the tumor was missed and further resection was indicated, during which a bleeding due to an injury of the pulmonary artery occurred. After successful control of the bleeding, the lobectomy was completed without adverse events.
The postoperative course was uneventful, and the patient was discharged on the sixth postoperative day. Pathologic investigation revealed that the tumor was a 1.1 cm squamous cell carcinoma of the lung (in situ component), and the final stage was pT1a2N0M0.
excellent resultant save.
it does appear that your staple technique/approach/angle places a great deal of traction/tension/torsion on the PA segmental branches. I myself find much fear if I am torquing the vessels to such a degree.