The detection rates of pulmonary nodules and early-stage lung cancer are rising year on year, which underscores the clinical value of sublobar resections including lung segmentectomy. CT-based three-dimensional reconstruction can intuitively visualize the anatomical courses and variants of bronchial and pulmonary vascular structures (arteries and veins), thereby providing accurate guidance for preoperative localization, surgical planning and intraoperative identification. This article systematically reviews the anatomical classification patterns of the bronchi and pulmonary vessels in the right upper, middle, and lower lobes at the segmental and subsegmental levels, and summarizes clinically significant variations, including tracheal bronchus, common arterial trunk, right top pulmonary vein, lingular-like bronchial configuration of the middle lobe, ectopic venous drainage, the subsuperior segment ("star segment") variation, and the relationship of B7/A7 to the inferior pulmonary vein, analyzing their impact on intraoperative anatomical judgment and treatment strategies for bronchial and vessels. This review aims to provide an anatomical basis and clinical reference for individualized precise segmentectomy and complex sublobar resection, so as to maximize preservation of pulmonary function while ensuring oncologic radicality and reducing the risk of surgical complications.
