Anatomical study of the left superior mediastinal lymphatics for tracheal branches of left recurrent laryngeal nerve-preserving mediastinoscope-assisted surgery in esophageal cancer
Anatomical study of the left superior mediastinal lymphatics for tracheal branches of left recurrent laryngeal nerve-preserving mediastinoscope-assisted surgery in esophageal cancer
复制标题
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
DOI：
10.1007/s00595-017-1600-0
复制
发表时间：
2018
期刊：
影响因子：
2.5
通讯作者：
T. Kawano
中科院分区：
文献类型：
--
作者：
Y. Nakajima;Y. Tokairin;Y. Nakajima;K. Kawada;K. Nagai;K. Yamaguchi;K. Akita;T. Kawano
食管癌的根治性治疗除了食管切除术外，还需要细致的上级纵隔淋巴结切除术，因为食管癌中上级纵隔淋巴结转移是常见的。在保留左喉返神经气管支时，需要对淋巴管走行、淋巴结分布、左喉返神经及其气管支的位置关系有较好的解剖学认识。我们对这些关系进行了详细的解剖学检查。方法对尸体进行宏观解剖学观察和组织学检查，除苏木素和伊红染色外，还使用抗podoplanin抗体D2-40进行免疫染色结果左喉返神经的气管支清晰可见，结论在左侧上级纵隔未见跨越喉返神经气管支平面的复杂淋巴管网络结构。这表明，通过使用左颈入路的肺纵隔方法切除左RLN周围的淋巴结，可以通过保持切除准确性来保留左RLN的气管分支。
PurposeCurative treatment of esophageal cancer requires meticulous superior mediastinal lymphadenectomy, in addition to esophagectomy, because superior mediastinal lymph node metastases are common in esophageal cancer. When preserving the tracheal branches of the left recurrent laryngeal nerve (RLN), good anatomical understanding is required for confirmation of the positional relationships between the courses of lymphatic vessels, lymph node distribution, and the left RLN and its tracheal branches. We performed a detailed anatomical examination of these relationships.MethodsMacroscopic anatomical observation and histological examination was performed on cadavers. In addition to hematoxylin and eosin staining, immunostaining using antipodoplanin antibody D2-40 (podoplanin) was performed to identify the lymphatic vessels.ResultsThe tracheal branches of the left RLN were clearly observed, but no lymphatic vessels crossing the ventral or dorsal side of the branches were identified either macro-anatomically or histologically.ConclusionNo complex lymphatic network structure straddling the plane composed of tracheal branches of the left RLN was found in the left superior mediastinum. This suggests that dissection of the lymph nodes around the left RLN via the pneumomediastinum method using the left cervical approach may allow preservation of the tracheal branches of the left RLN by maintaining dissection accuracy.
影响因子：
3.8
作者：
Law, S;Fok, M;Wong, J
通讯作者：
Wong, J