颈胸结合部前路手术入路的解剖学分析

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1、万方数据颈胸结合部前路手术入路的解剖学研究PartIIAntomystudyofanteriorsurgicalapproachviasubtotalexcisionofsternalmanubriumoHectives：Tostudythemethodandrangeofexposionforananteriorsurgicalapproachestocervicothoracicspineviasubtotalexcisionofsternalmanubrium．Thentoclarifytheanatomiccharacteristicsofassociatedimpo

2、rtantstructuresofthesetheapproach．Meanwhile,tomakeassessmentofthefeasibilityofit．MaterialsandMethods：Prepare7adultfresh‘frozencadaversandmakesubtotalexcisionofsternalmanubriumwithsternoclavicularjointpreserved．Theosseouswindowismadefromjugularnotchupwardlytosternalangledownwardly,andbetween

3、theboundaryofsternalmanubriumlaterally．Thenmakebluntdissectionofsuperiormediastiniumtofindthegreatvessels．Exposingthevertebraeofcewicothoracicthroughthreedifferentspace：thespacebetweenbranchiocephalictrunkandrightbranchiocephalicvein，thespacebetweenbranchiocephalictrunkandtracheaalongwithes

4、ophagus,thespacebetweentracheaalongwithesophagusandleftcommoncarotidartery．Aftercompletetheexposion,makecleartherangeofexposionofdifferentspacefromproximaltocaudalbymeansofbonelandmarksorfluoroscopy．Andthenstudythecharacteristicsofapproach-relatedimportantanatomicalstructuresResults：Aftersu

5、btotaIexcisionofsternaImanubriumtoexposeanteriorofcervicothoracicspine，wefoundthattheanteriorofcervicothoracicvertebraecanbeexposedthroughthreespaces：thespacebetweenbranchiocephalictrunkandrightbranchiocephalicvein，thespacebetweenbranchiocephalictrunkandtracheaalongwithesophagus．thespacebet

6、weentracheaalongwithesophagusandleftcommoncarotidartery．Thegoodrealizationisachievedbypullingtheimportantstructuresincludingbranchiocephalictrunkbranchiocephalicvein，leftcommoncarotidartery,esophagusandtrache．Therangeofexposionofthesethreespacesvarieseachother,ofwhichtheexposionextentofthes

7、pacebetweenrightbranchiocephalicveinandbranchiocephalictrunkisthelargestrelatively．Alsotheexposionextentvariesindividually．Conclusion：Theanatomystudyshowtheapproachtocervicothoracicspine6万方数据throughsubtotalexcisionofsternalmamubriumallowsagoodaccesstothe