PS01.031: REVISITING THE ESOPHAGOGASTRIC JUNCTION ANATOMY: WHERE IS THE INFRACARDIAC BURSA?

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 58-59
Author(s):  
Tatsuro Nakamura ◽  
Hisashi Shinohara ◽  
Tomoaki Okada ◽  
Shigeo Hisamori ◽  
Shigeru Tsunoda ◽  
...  
Keyword(s):  
Esophagogastric Junction ◽  
Conflicts Of Interest ◽  
Three Dimensional ◽  
Human Embryos ◽  
Closed Space ◽  
Mr Images ◽  
Crown Rump Length ◽  
Transhiatal Approach ◽  
Dimensional Reconstruction ◽  
The Right

Abstract Background The infracardiac bursa (ICB), the closed space encountered in the esophagogastric junction (EGJ) surgery, is rarely described in anatomical atlases. The purpose of the study is to link surgery to embryology and propose the new anatomical chart including the ICB. Methods Histological serial sections of Carnegie stages (CS) 13–23 embryos and magnetic resonance (MR) images of the fetus with 43.5 mm crown-rump length from the Kyoto Collection of Human Embryos were examined for embryological changes in the ICB. Seventy-four surgery videos of laparoscopic and thoracoscopic esophagectomy were reviewed to investigate the appearance of the ICB and frequency of the recognition in surgery. Results The right pneumato-enteric recess appeared in CS13 embryos and the ICB was separated from the recess by the development of the diaphragm between CS17 and CS18 embryos and established as a closed space up until CS23. The three-dimensional reconstruction of fetus MR images showed the ICB was located adjacent nearly one third around the esophagus above the right crus. The ICB was clinically encountered in 12 of 14 (86%) transhiatal surgeries and 23 of 60 (38%) thoracic surgeries. Via the transhiatal approach, the caudal edge of the ICB appeared as a thick whitish membrane after the dissection of the phrenico-esophageal ligament and a closed space enveloped with a serosa was opened by the incision of the membrane. Via the right thoracic approach, the ICB appeared on the right crus after the dissection of the pulmonary ligament. Conclusion We described a new chart around EGJ including the ICB based on embryology. This anatomical chart can contribute to promote accuracy and safety of operating procedures around the EGJ. Disclosure All authors have declared no conflicts of interest.

VS01.06: THORACOSCOPIC EXTENDED LYMPHADENECTOMY FOR EGJ CANCER: AN OPTION TO LEARN FROM THE EAST

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 45-45
Author(s):  
Simone Giacopuzzi ◽  
Jacopo Weindelmayer ◽  
Giovanni De Manzoni
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Recurrent Laryngeal Nerve ◽  
Esophagogastric Junction ◽  
Conflicts Of Interest ◽  
Laryngeal Nerve ◽  
Extended Lymphadenectomy ◽  
Node Dissection ◽  
Node Metastasis ◽  
The Right

Abstract Description Extended thoracoscopic lymphadenectomy is not common practice in Western countries in patients with adenocarcinoma of the esophagogastric junction. In this video we present a case of a patient with siewert I adenocarcinoma with lymph node metastasis to the right recurrent laryngeal nerve not treated with neoadjuvant therapy, due to comorbidity. The operation was: extended thoracoscopic en-block lymph node dissection. video will be edited in a more rigorous manner Disclosure All authors have declared no conflicts of interest.

PS01.191: LAPAROSCOPIC TRANSHIATAL LOWER MEDIASTINAL LYMPHADENECTOMY FOR ESOPHAGOGASTRIC JUNCTIONAL CANCER: THE INFRACARDIAC BURSA AS A LANDMARK

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 104-104
Author(s):  
Yasunori Kurahashi ◽  
Tatsuro Nakamura ◽  
Rie Ozawa ◽  
Yasutaka Nakanishi ◽  
Hirotaka Niwa ◽  
...  
Keyword(s):  
Lymph Node ◽  
Esophagogastric Junction ◽  
Conflicts Of Interest ◽  
Ventral Side ◽  
Dorsal Side ◽  
Node Dissection ◽  
Mediastinal Lymphadenectomy ◽  
Operating Field ◽  
Esophagogastric Junction Cancer ◽  
The Right

Abstract Background Esophagogastric junction cancer has been increasing recently. As a result, opportunities to perform transhiatal lower mediastinal lymphadenectomy are also increasing. Laparoscopic surgery is useful because the operating field of this site is too deep and narrow to perform laparotomy. But the anatomy of this area is not sufficiently clarified, and since there are few structures as landmarks, it is difficult to set the range and depth of lymph node dissection. Methods We have been verifying anatomically and embryologically the infracardiac bursa (ICB) identified as a closed lumen between the esophagus and the right crus of the diaphragm during an operation. We standardized the procedure of transhiatal lower mediastinal lymphadenectomy setting several landmarks including ICB. Results In transhiatal lower mediastinal lymphadenectomy, it is possible to do a precise lymphadenectomy by setting several landmarks including the ICB and standardizing each procedure on the ventral side, dorsal side, and both sides of the esophagus. In the case of advanced cancer which invades organs around the hiatus, it is difficult to perform routine dissection by using the infracardiac bursa or the dissectable layer. Understanding of the anatomy of this area will support the safe and precise lymphadenectomy. Conclusion In this presentation, we will show the procedure of transhiatal lower mediastinal lymphadenectomy using the ICB as a landmark. Disclosure All authors have declared no conflicts of interest.

Development of the human pulmonary vein and its incorporation in the morphologically left atrium

2001 ◽  
Vol 11 (6) ◽  
pp. 632-642 ◽  
Author(s):  
Sandra Webb ◽  
Mazyar Kanani ◽  
Robert H. Anderson ◽  
Michael K. Richardson ◽  
Nigel A. Brown
Keyword(s):  
Left Atrium ◽  
Pulmonary Vein ◽  
Pulmonary Veins ◽  
Venous Sinus ◽  
Human Embryos ◽  
Crown Rump Length ◽  
Prepared Material ◽  
Marked Disparity ◽  
Dorsal Mesocardium ◽  
The Right

Objective: Using a newly acquired archive of previously prepared material, we sought to re-examine the origin of the pulmonary vein in the human heart, aiming to determine whether it originates from the systemic venous sinus (“sinus venosus”), or appears as a new structure draining to the left atrium. In addition, we examined the temporal sequence of incorporation of the initially solitary pulmonary vein to the stage at which four venous orifices opened to the left atrium. Methods: We studied 26 normal human embryos, ranging from 3.8 mm to 112 mm crown-rump length, and representing the period from the 12th Carnegie stage to 15 weeks of gestation. Results: The pulmonary vein canalised as a solitary vessel within the mediastinal tissues so as to connect the intraparenchymal pulmonary venous networks to the heart, using the regressing dorsal mesocardium as its portal of cardiac entry. The vein was always distinct from the tributaries of the embryonic systemic venous sinus. The orifice of the solitary vein became committed to the left atrium by growth of the vestibular spine. During development, a marked disparity was seen between the temporal and morphological patterns of incorporation of the left-sided and right-sided veins into the left atrium. The pattern of the primary bifurcation was asymmetrical, a much longer tributary being formed on the left than on the right. Contact between the atrial wall and the venous tributary on the left initially produced a shelf, which became effaced with incorporation of the two left-sided veins into the atrium. Conclusions: The initial process of formation of the human pulmonary vein is very similar to that seen in animal models. The walls of the initially solitary vein in humans become incorporated by a morphologically asymmetric process so that four pulmonary veins eventually drain independently into the left atrium. Failure of incorporation on the left side may provide the substrate for congenital division of the left atrium.

Double aortic arch presenting with a foreign object in the oesophagus: a case report and imaging diagnosis

2017 ◽  
Vol 27 (8) ◽  
pp. 1651-1653
Author(s):  
Xiuzhen Yang ◽  
Jingjing Ye ◽  
Zhan Gao
Keyword(s):  
Aortic Arch ◽  
Ct Angiography ◽  
Subclavian Artery ◽  
Three Dimensional ◽  
Double Aortic Arch ◽  
Foreign Object ◽  
Right Loop ◽  
Dimensional Reconstruction ◽  
History Of ◽  
The Right

AbstractIn this article, we report a rare case of double aortic arch. The case presented initially with a foreign object in the oesophagus. The patient was a 2-year-old boy, who was referred with primary symptoms of tussis (15 days) and emesis (2 days). He had a history of ingesting a coin. Routine chest X-ray indicated a rounded, metal foreign object in the upper oesophagus. A half-Yuan coin was removed by gastroduodenoscopy. Echocardiographic imaging suggested that the patient had double aortic arch, which was subsequently diagnosed by CT angiography with three-dimensional reconstruction. The right subclavian artery arose from the right loop of the double aortic arch. The left subclavian artery as well as left and right common carotid arteries had distinct origins from the left aortic arch. Imaging also indicated atresia of the distal left arch. The patient underwent corrective surgery and made a full recovery. Despite the rarity, double aortic arch should be considered when patients present with a foreign object in the oesophagus. Echocardiography and CT angiography can inform the diagnosis.

Agenesis of the right lung diagnosed by three-dimensional reconstruction of helical chest CT

1996 ◽  
Vol 69 (827) ◽  
pp. 1052-1054 ◽  
Author(s):  
C T Wu ◽  
M R Chen ◽  
S L Shih ◽  
F Y Huang ◽  
S H Hou
Keyword(s):  
Three Dimensional ◽  
Chest Ct ◽  
Three Dimensional Reconstruction ◽  
Dimensional Reconstruction ◽  
The Right

Three-Dimensional Reconstruction of TMJ MR Images: A Technical Note and Case Report

CRANIO® ◽  
2004 ◽  
Vol 22 (1) ◽  
pp. 77-81 ◽  
Author(s):  
Noriyuki Kitai ◽  
Lars Eriksson ◽  
Sven Kreiborg ◽  
Aase Wagner ◽  
Kenji Takada
Keyword(s):  
Case Report ◽  
Three Dimensional ◽  
Technical Note ◽  
Three Dimensional Reconstruction ◽  
Mr Images ◽  
Dimensional Reconstruction

scholarly journals Plicae Palmatae on MR in Uterus Didelphys: the Incidence and Morphological Characteristics

2021 ◽  
Vol 2 (6) ◽  
pp. 01-03
Author(s):  
Wang Xiaoying
Keyword(s):  
Three Dimensional ◽  
Morphological Characteristics ◽  
Reproductive Age ◽  
Mr Images ◽  
Uterus Didelphys ◽  
Significant Difference ◽  
Cervical Disease ◽  
Left And Right ◽  
The Right ◽  
Plicae Palmatae

Objective: To investigate the incidence of plicae palmatae in uterus didelphys and its morphological characteristics on MR imaging. Methods: We retrospectively collected 37 consecutive female pelvic MR images diagnosed with uterus didelphys between August 2012 and November 2020. Patients with the following conditions were excluded: (a) repeated examination; (b) poor image quality; (c) cervical disease. Axial and coronal T2-weight images and axial three-dimensional (3D) volumetric isotropic T2-weighted acquisition (VISTA) were used to evaluate the ridge of plicae palmatae (RPP). A multiplanar reformation of the cervical axis from 3D-VISTA sequence was performed to measure the height and width of RPP. Non-normal variables based on the Kruskal-Wallis H test was used for statistical analysis. A two-tailed test where P < 0.05 was considered statistically significant. Results: Twenty-six cases were finally included in the statistics. The average age was 25.7±9.0 years (range, 10-45 years). RPP was observed on both cervices in 16 patients (61.5%), only on the left cervix in 3 patients (11.5%), and only on the right cervix in 4 patients (15.4%). There were 3 cases with no RPP observed in any of their cervix (11.5%).All RPP appear symmetrically on the anterior and posterior walls of the cervix. There was no statistically significant difference in height, width, and height/width of the RPP in the left and right cervix (p＞0.05). Conclusions: RPP is encountered in 88.5% patients with duplicated uterine cervices in our cohort. This incidence is similar to that reported in women with normal uterus of reproductive age.

scholarly journals MORPHOLOGICAL FEATURES OF FASCIAL STRUCTURES IN INFRAHYOID NECK DURING PRENATAL HUMAN ONTOGENESIS

2020 ◽  
Vol 19 (1) ◽  
pp. 93-97
Author(s):  
I. Popova
Keyword(s):  
Three Dimensional ◽  
Prenatal Development ◽  
Human Embryos ◽  
Human Ontogenesis ◽  
Dimensional Reconstruction ◽  
Depth Study ◽  
Fascial Spaces ◽  
Human Prenatal Development ◽  
Macroscopic Examination ◽  
Fetal Stage

Fascia and fascial spaces of the neck remains a controversial morphological question, which requires in-depth study, especially in the focus of prenatal morphogenesis. We have examined specimens of human embryos, prefetuses and fetuses in order to study the development and topographic-anatomical features of the neck fascial structures at different stages of human prenatal development. For this purpose, a set of microscopic methods (three-dimensional reconstruction, series of histological sections examination) for embryos (8.0-13.0 mm PCL (parieto-coccygeal length) and prefetuses (14.0-80.0 mm PCL) was used; macroscopic examination for fetuses’ specimens (80.0-230.0 mm PCL). It was found that at the end of the embryonic period of development, there are rudiments of the larynx and pharynx, which are not delimited; precrusors of vascular and nerve trunks of the neck are already present. In the prefetal we may observe change from the bilaminar to multilaminar fascial morphology. The definitive structure of fascial structures may be found in fetal stage of human ontogenesis. It is important that at fetal stage, fascial leaves tend to fuse in areas that contact with the periosteum or in the fascial spaces that do not yet contain adipose tissue yet.

scholarly journals Early development of human ganglionic eminences assessed in vitro by using 7.04 Tesla micro-MRI – a pilot study

2020 ◽  
Author(s):  
Dan Boitor-Borza ◽  
Flavius Turcu ◽  
Stefan Farcasanu ◽  
Carmen Crivii
Keyword(s):  
Spatial Resolution ◽  
Morphological Characteristics ◽  
Human Embryos ◽  
Mr Images ◽  
Crown Rump Length ◽  
Gestational Week ◽  
Human Embryos And Fetuses ◽  
Ganglionic Eminences ◽  
Morphological Research

Background and aims. Ganglionic eminences are temporary structures which appear during the 5th week post-fertilization on the floor of telencephalic vesicles and disappear until the 35th week of gestation. The aim of this descriptive study of morphological research is to depict the ganglionic eminences within the embryonic and early fetal brains by using micro-MRI. Methods. Six human embryos and fetuses ranging from 21 mm crown-rump length CRL (9 gestational week GW) to 85 mm CRL (14 GW) were examined in vitro by micro-MRI. The investigation was performed with a Bruker BioSpec 70/16USR scanner (Bruker BioSpin MRI GmbH, Ettlingen, Germany) operating at 7.04 Tesla. Results. We describe the morphological characteristics of the ganglionic eminences at different gestational ages. The acquisition parameters were modified for each subject in order to obtain an increased spatial resolution. The remarkable spatial resolution of 27 µm/voxel allows visualization of millimetric structures of the developing brain on high quality micro-MR images. Conclusion. In our study we give the description of the ganglionic eminences within the embryonic and early fetal brains by using micro-MRI, which have not been previously documented in literature. Micro-MRI provides accurate images, which are comparable with the histological slices.

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