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Clinical anatomical basis for the development of function preserving cancer operations with special reference the pharyngeal plexus and to the pharyngo-esophageal branches of the recurrent laryngeal nerve

保留功能的癌症手术发展的临床解剖学基础，特别涉及咽丛和喉返神经的咽食管分支

基本信息

批准号：
11671673
负责人：
SATO Tatsuo
金额：
$ 1.54万
依托单位：
Tokyo Medical and Dental University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1999
资助国家：
日本
起止时间：
1999 至 2000
项目状态：
已结题

项目摘要

Clinical anatomical basis for the development of function preserving cancer operations with special reference to the pharyngeal plexus and to the pharyngo-esophageal branches of the recurrent laryngeal nervesIn this study we minutely examined the vagal and sympathetic distribution to the larynx, trachea and esophagus in order to obtain an anatomical basis for the development of new function preserving cancer operations of these areas. Cadaveric dissections were performed from the dorsal aspect after the removal of the vertebral column and the ribs. Above the tracheal bifurcation the tracheal and esophageal branches of the vagus tended to originate as common trunks. These common trunks passed between the trachea and esophagus and divided into the proper twigs just before entering the respective organs : the esophageal branches entered the anterior wall of the esophagus, while the tracheal branches entered the posterior membranous wall of the trachea. Within the latter wall rich communic … More ations between the ipsilateral branches were observed, however, no communications were observed between the right and left tracheal and esophageal branches. At the level of the tracheal bifurcation numerous communications were found between the right and left common trunks of the bronchial and esophageal branches. Each bronchus received supplying branches from the vagus of the same side, however, no branches from the opposite side vagus were detected. Below the tracheal bifurcation the right and left vagi divided into several major branches which communicated and formed the esophageal plexus surrounding the esophagus. This plexus issued numerous esophageal branches which entered the surface of the esophagus ; intramural communications were also observed. As to the lymphatics of the esophagus, communications between the right and left lymph vessels were observed on the posterior surface of the esophagus. According to the accompanying structures these lymphatics were classified into four : 1) lymphatics independent of blood vessels and/or nerves, 2) lymphatics along the bronchial arteries, 3) lymphatics along the hemiazygos vein, and 4) lymphatics along the posterior intercostal arteries. Efferent lymphatics from the lymph nodes of the tracheal bifurcation ran along the communicating branches between the right and left vagi. Less

本文详细观察了喉、气管和食管的迷走神经和交感神经分布，为今后开展保留喉、气管和食管功能的肿瘤手术提供了解剖学基础。在移除脊柱和肋骨后，从背侧进行尸体解剖。在气管分叉以上，迷走神经的气管支和食管支趋向于起源于共同的干。这些共同的主干穿过气管和食管之间，在进入各自的器官之前分成适当的分支：食管分支进入食管的前壁，而气管分支进入气管的后膜壁。在后一堵墙里， ...更多信息观察到同侧支之间的交通，然而，未观察到左右气管支和食管支之间的交通。在气管分叉水平，在支气管和食管分支的右和左共同干之间发现了许多交通。各支气管均接受同侧迷走神经的供血支，但未检测到来自对侧迷走神经的支。在气管分叉以下，左右迷走神经分为几个主要分支，这些分支相互沟通，形成食管周围的食管丛。该丛发出许多进入食管表面的食管分支;还观察到壁内交通。在食管的分支中，在食管的后表面观察到左右淋巴管之间的交通。根据其伴行结构可分为4类：（1）不依赖血管和/或神经的分支，2）沿支气管动脉沿着分支，3）沿半奇静脉沿着分支，4）沿肋间后动脉沿着分支。气管分叉淋巴结的传出神经沿着左右迷走神经间的交通支。少