Histological study of the thin membranous dense connective tissues around the curving portion of the bilateral recurrent laryngeal nerves
Histological study of the thin membranous dense connective tissues around the curving portion of the bilateral recurrent laryngeal nerves
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双侧喉返神经弯曲部周围薄膜致密结缔组织的组织学研究
DOI：
10.1007/s10388-023-00991-4
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发表时间：
2023
期刊：
影响因子：
2.4
通讯作者：
Kinugasa Yusuke
中科院分区：
文献类型：
--
作者：
Tokairin Yutaka;Kawamura Yudai;Muro Satoru;Nagai Kagami;Kawada Kenro;Okada Takuya;Tharnmanularp Suthasinee;Jiamjunyasiri Areeya;Akita Keiichi;Kinugasa Yusuke
目的/目的研究喉返神经(RLN)、薄膜性致密结缔组织(TMDCT)与食道周围淋巴结之间的解剖关系，为合理、有效地清扫喉返神经弯曲段的食道周围淋巴结提供解剖学基础。结果内脏鞘不能清楚地观察到双侧RLN的弯曲部分，主要位于大血管(主动脉弓和右锁骨下动脉[SCA])的头侧和内侧。双侧迷走神经与血管鞘一起走行，绕大血管尾侧和血管鞘而上，向内脏鞘内侧走行。左侧气管-支气管区(编号106tbL)或右侧返神经淋巴结(编号106recR)周围未见内脏鞘。在内脏鞘内侧观察到含有左侧返神经淋巴结(编号106recL)和右侧颈部食道旁淋巴结(编号101R)的区域。结论返神经从迷走神经发出的分支沿血管鞘下行，内翻后沿内脏鞘内侧上行。然而，在内翻区找不到清晰的内脏鞘。因此，在根治性食道切除术中，101R或106recL沿线的内脏鞘是可以识别和利用的。
Objective/AimWe aimed to demonstrate the anatomical relationship between the recurrent laryngeal nerves (RLNs), thin membranous dense connective tissue (TMDCT [e.g., the visceral or vascular sheaths around the esophagus]), and the lymph nodes around the esophagus at the curving portion of the RLNs for rational and efficient lymph node dissection.MethodsTransverse sections of the mediastinum at 5 mm or 1 mm intervals were obtained from four cadavers. Hematoxylin and eosin staining and Elastica van Gieson staining were performed.ResultsThe visceral sheaths could not be clearly observed the curving portions of the bilateral RLNs, which were observed on the cranial and medial side of the great vessels (aortic arch and right subclavian artery [SCA]). The vascular sheaths could be clearly observed.The bilateral RLNs diverged from the bilateral vagus nerves, which ran along with the vascular sheaths, went up around the caudal side of the great vessels and the vascular sheath, and ran cranially on the medial side of the visceral sheath. Visceral sheaths were not observed around the region containing the left tracheobronchial lymph nodes (No. 106tbL) or the right recurrent nerve lymph nodes (No. 106recR). The regions containing the left recurrent nerve lymph nodes (No. 106recL) and the right cervical paraesophageal lymph nodes (No. 101R) were observed on the medial side of the visceral sheath, with the RLN.ConclusionThe recurrent nerve, which branched off from the vagus nerve descending along the vascular sheath, ascended the medial side of the visceral sheath after inversion. However, no clear visceral sheath could be identified in the inverted area. Therefore, during radical esophagectomy, the visceral sheath along No. 101R or 106recL may be recognized and available.
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日本食管癌的分类，第11版：第一部分。
DOI：
10.1007/s10388-016-0551-7
发表时间：
2017
期刊：
Esophagus : official journal of the Japan Esophageal Society
影响因子：
--
作者：
Japan Esophageal Society
通讯作者：
Japan Esophageal Society
食管癌保留喉返神经手术中左上纵隔淋巴管气管分支的解剖学研究
影响因子：
2.5
作者：
Y. Nakajima;Y. Tokairin;Y. Nakajima;K. Kawada;K. Nagai;K. Yamaguchi;K. Akita;T. Kawano
通讯作者：
T. Kawano
日本食管癌的分类，第11版：第二部分和III。
DOI：
10.1007/s10388-016-0556-2
发表时间：
2017
期刊：
Esophagus : official journal of the Japan Esophageal Society
影响因子：
--
作者：
Japan Esophageal Society
通讯作者：
Japan Esophageal Society
影响因子：
2.4
作者：
Tokairin, Yutaka;Nakajima, Yasuaki;Kinugasa, Yusuke
通讯作者：
Kinugasa, Yusuke
[关于胸膜间韧带（De Morosow）的考虑]。
DOI：
--
发表时间：
1961
期刊：
Archives d'anatomie pathologique
影响因子：
--
作者：
P. Meyer;R. Sublon
通讯作者：
R. Sublon