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

发展保功能癌手术的临床解剖学基础，特别涉及咽丛和喉返神经咽-食道分支本研究详细检查了喉、气管和食道的迷走神经和交感神经分布，以期为发展这些区域的保功能癌手术提供解剖学基础。在切除脊柱和肋骨后，从背侧进行尸体解剖。在气管分叉的上方，迷走神经的气管分支和食管分支往往起源于共同的干。这些共同的树干在气管和食道之间穿过，并在进入各自的器官之前分成适当的小枝：食道分支进入食道前壁，而气管分支进入气管后膜壁。后侧壁内有丰富的通讯。同侧气管分支间通讯较多，而左右气管分支与食管分支间通讯较少。在气管分叉的水平上，在支气管分支和食管分支的左右总干之间发现了大量的交通。各支气管均有同侧迷走神经分支，未见对侧迷走神经分支。在气管分叉的下面，左右迷走神经分成几个主要的分支，这些分支相互联系并形成围绕食道的食道神经丛。这个神经丛发出许多食道分支，进入食道表面；还观察到校内通信。食道的淋巴管，在食道后表面可见左右淋巴管相通。根据淋巴管的结构可分为四种：1)无血管和/或神经的淋巴管，2)沿支气管动脉的淋巴管，3)沿半奇静脉的淋巴管，4)沿后肋间动脉的淋巴管。从气管分叉的淋巴结传出的淋巴沿着左右迷走神经之间的交通分支。少

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