Clinical Effect of the Preservasion of Cardiac Branch of the Right Vagal Nerve on the Post-Operative Condition after the Resection of Esophageal Cancer with 3-Regional Lymph Nodes Dissection

Abstract Background Minimally invasive approach to esophageal cancer has been accepted as the standard of care in many centers. Nontheless, some technical difficulties are encountered during surgery. A proper vascularization of the gastric tube is mandatory to avoid the dreadful complication of a leak or of gastric conduit necrosis. On the other hand, there is controversy on the identification of sentinel lymph node in early esophageal cancer and on the extent of lymphadenectomy in locally advanced tumours. Indocyanine green (ICG) is a sterile, anionic, water-soluble but relatively hydrophobic, tricarbocyanine molecule, which is bound to plasma proteins when intravenously injected. It is extracted by the liver appearing in the bile around 8 minutes after injection. When injected outside the blood vessels, ICG reaches the nearest lymph node within 15 minutes and after 1 to 2 hours it binds to the regional lymph nodes. The usual dose of ICG is 0.1 - 0.5mg/mL/kg. ICG becomes fluorescent once excited with near-infrared (NIR) light at about 820 nm. The fluorescence released by ICG may be detected using specially developed cameras. Methods A systematic review of the literature of ICG in esophageal surgery was carried on February 2018 using the following terms: esophagus, indocyanine green, ICG, surgery, angiography, lymph node, and combinations of the above. Results The technique of ICG angiography for vascular assessment of the gastroepiploic arcade and gastric conduit is explained and the published results are review. The use of ICG for the evaluation of sentinel lymph node in early esophageal cancer and of lymph node mapping for regional lymph nodes is explained and current evidence is reviewed. Conclusion ICG use in esophageal surgery is still a novel and promising technique. It could help to reduce anastomotic leak by means of vascular assessment of the gastric conduit, locate lymph nodes out of the usual fields of lymphadenectomy and locate the sentinel lymph node in early esophageal cancer Disclosure All authors have declared no conflicts of interest.

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PS01.235: THE METHOD AND THE SHORT OUTCOME OF MEDIASTINAL LYMPH NODES DISSECTION FOR ESOPHAGEAL CANCER USING A TRANS-BICERVICAL AND TRANSHIATAL APPROACH UNDER THE PNEUMOMEDIASTINUM

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.235 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 116-116

Author(s):

Yutaka Tokairin ◽

Yasuaki Nakajima ◽

Kenro Kawada ◽

Akihiro Hoshino ◽

Takuya Okada ◽

...

Keyword(s):

Esophageal Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Recurrent Nerve ◽

Node Dissection ◽

Radical Esophagectomy ◽

Transhiatal Approach ◽

Cervical Approach ◽

Thoracic Approach ◽

The Right

Abstract Background We previously reported the performance of mediastinoscopic esophagectomy with lymph node dissection (MELD) under pneumomediastinum using a transcervical and transhiatal approach as a method of radical esophagectomy. For more complete lymph node dissection, it is necessary to dissect via not only left cervical but also right cervical approach in pneumomediastinum. We herein report the dissection method for upper mediastinum using a cervico-pneumomediastinal approach including right cervical approach in pneumomediastinum and the short surgical outcome. Methods This method was applied to nine cases for esophageal cancer. The right recurrent nerve was first identified using an open approach. Pneumomediastinum was then initiated to allow for the 105 and 106recR lymph nodes to be completely dissected along the right mediastinal pleura, the right vagus nerve, the proximal portion of the azygos vein and the right bronchial artery. The left recurrent nerve (106recL) lymph nodes and 106tbL lymph nodes were dissected using a cross-over technique, as described previously. Results This operation using bilateral cervical approach in pneumomediastinum were performed for nine cases. The median operation time and bleeding is 606 minutes and 506 ml, respectively. The median post-operative stay is 15 days. Conclusion MELD is therefore considered to be a more minimally invasive and useful modality for radical esophagectomy than the thoracic approach, although the field of view is different from that of the thoracic approach. Disclosure All authors have declared no conflicts of interest.

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Safety and feasibility of near-infrared image-guided lymphatic mapping of regional lymph nodes in esophageal cancer

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2016.04.025 ◽

2016 ◽

Vol 152 (2) ◽

pp. 546-554 ◽

Cited By ~ 27

Author(s):

Krista J. Hachey ◽

Denis M. Gilmore ◽

Katherine W. Armstrong ◽

Sean E. Harris ◽

Jason L. Hornick ◽

...

Keyword(s):

Esophageal Cancer ◽

Lymph Nodes ◽

Near Infrared ◽

Lymphatic Mapping ◽

Infrared Image ◽

Regional Lymph Nodes ◽

Image Guided

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Transcoelomic and Lympho-Hematogenous Dissemination of Endometrioid Heterotopias – the Mechanism of Extragenital Endometriosis Formation

Journal of Anatomy and Histopathology ◽

10.18499/2225-7357-2021-10-1-85-91 ◽

2021 ◽

Vol 10 (1) ◽

pp. 85-91

Author(s):

R. V. Ukrainets ◽

Yu. S. Korneva

Keyword(s):

Lymph Nodes ◽

Vena Cava ◽

The Body ◽

Lung Damage ◽

Pelvic Cavity ◽

Regional Lymph Nodes ◽

Normal Endometrium ◽

Pulmonary Endometriosis ◽

Extragenital Endometriosis ◽

The Right

Endometriosis nowadays still a disease with an undisclosed pathogenesis. This article demonstrates and explains the possibility of different variants of dissemination of endometrioid cells in the body with the formation of foci of extragenital endometriosis in organs and tissues remote from the pelvis, complementing and confirming the theory of utero-peritoneal reflux in the development of endometriosis as the most reasonable. Endometrioid heterotopias have a more developed lymphatic network compared to the normal endometrium due to active lymphangiogenesis, and, having a tendency to invasive growth, endometrioid heterotopia is a source of endometrioid cells spreading along the direction of lymph outflow from the most typical locations (pelvic organs) with damage to the inguinal and pelvic lymph nodes. Lymphatic dissemination in adenomyosis is observed in every fourth patient, which requires revision of the surgery protocol with excision of regional lymph nodes to prevent relapses. The presence of cases of pulmonary endometriosis and endometrioid liver cysts makes hematogenic dissemination of endometriosis from the primary source in the pelvic region obvious. The most frequent localizations of endometrioid heterotopias are located near the corresponding venous plexuses of the small pelvis, the outflow from which occurs mainly through the inferior vena cava, without anatomical obstacles for hematogenic dissemination of endometrioid cells with subsequent lung damage. For liver involment, it is likely that endometriosis in the distal parts of the colon is important, the venous outflow from which is directed to the portal vein system. Endometriosis of the diaphragm – is an example transcoelomic spread with predominant location on the right dome of the diaphragm, as the right subphrenic space communicates with the pelvic cavity through the right lateral channel, which justifies the possibility of such involments of the diaphragme in context of the theory of uteroperitoneal reflux.Thus, the theory of menstrual regurgitation and the theory of hemato-lymphatic dissemination are components of a single pathogenetic model of the distribution of endometrioid cells in the body.

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Патоморфологічна характеристика хламідіозу в котів

Scientific Messenger of LNU of Veterinary Medicine and Biotechnology ◽

10.15421/nvlvet7703 ◽

2017 ◽

Vol 19 (77) ◽

pp. 11-14

Author(s):

V. Lisova ◽

A. Savchenko

Keyword(s):

Lymph Nodes ◽

Chlamydial Infection ◽

Historical Data ◽

Underlying Disease ◽

Regional Lymph Nodes ◽

Laboratory Methods ◽

Main Research ◽

Pathological Material ◽

The Right ◽

Lymphoid Nodules

The results of the study of the morphological features of pathological processes in organs and tissues of dead cats from chlamydial infection. A study of cadavers (n = 8), cats of different breeds aged from 3 to 6 years old, who lives with the laboratory methods have been diagnosed and identified the pathogen Chlamydia felis. According to historical data from sick animals were recorded various nature and degree of conjunctivitis and pronounced signs of a lesion of the respiratory tract (rhinitis, bronchitis, pneumonia). The main research method was mortem examination, during which the fixed and described the macroscopic changes in the affected organs and tissues. The autopsy was carried out partial evisceration, while selected pathological material for further histological studies. It is shown that the most pronounced damage and characteristic macroscopic changes all dead cats fixed contact in lung tissues and regional lymph nodes (mediastinal and bronchial), and in the spleen. Macroscopic picture of lungs affected varied somewhat depending on the degree of damage and stages of morphogenesis. In most cases (n = 6) lesions in the lungs looked like multiple well-defined lesions that are localized in all lobes of the lungs. Morphological manifestations of chlamydial infection in the investigated dead cats on the macroscopic level following features are: 1) productive inflammation in the lungs in a subtotal and total interstitial pneumonia and pulmonary fibrosis; 2) catarrhal bronchitis; 3) hyperplasia and serous lymphadenitis of the mediastinal and bronchial lymph nodes; 4) hyperplasia of lymphoid nodules of the spleen; 5) serous conjunctivitis. Also, a disease accompanied by nonspecific general pathological processes, such as: passive venous congestion of the liver and kidneys; degenerative changes in the liver; dilation of the right ventricle of the heart, which occurs as a complication of the underlying disease. While studies of other organs and tissues of dead animals we have not found any macroscopic changes.

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TRACHEO-ESOPHAGEAL STENTING IN THEIR TUMOR STENOSIS

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2016-175-1-74-77 ◽

2016 ◽

Vol 175 (1) ◽

pp. 74-77 ◽

Cited By ~ 1

Author(s):

E. A. Drobyazgin ◽

Yu. V. Chikinev ◽

I. E. Sudovykh ◽

M. S. Anikina

Keyword(s):

Esophageal Cancer ◽

Respiratory Failure ◽

Lymph Nodes ◽

Stent Implantation ◽

Esophageal Stenosis ◽

Patient Treatment ◽

Metastatic Lesions ◽

The Right ◽

Esophageal Stenting ◽

Made In

The article presents the results of diagnostics and treatment of 6 patients, whom the trachea-esophageal stenting was performed (5 men, 1 woman). The age of patients was from 49 to 78 years old. The indication to stent implantation was in cases of esophageal cancer in 4 patients. Metastatic lesions of the lymph nodes of the mediastinum was the reason of esophageal stenosis after previously performed surgery (type of Lewes operation) in one case. Another reason of surgery was central cancer of the right lung with invasion to the mediastinum, trachea and esophagus compression in one patient. Treatment management was determined by presence of respiratory failure and dysphagia evidence. The trachea stenting was carried out as the first stage of treatment in case of respiratory failure. The esophageal stenting was made in case of dysphagia. There weren’t any complications. The trachea-esophageal patency was restored.

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