Chinese Journal of Clinical Anatomy >
Applied anatomic study of video-assisted thoracoscopic ligation of thoracic duct
Received date: 2014-01-20
Online published: 2014-06-04
Objective To provide morphological basis for ligation of thoracic duct assisted by thoracoscopy. Methods An anatomical study was performed on ten normal adult cadavers to observe the original part of thoracic duct, cisterna chili, intestinal trunk, left and right lumbar trunks, the anatomical characteristics and distribution of the thoracic duct in the chest; and the distance from thoracic duct to the azygos vein, the hemiazygos vein and the accessory hemiazygos vein in the T4~12 segments was measured. Results ①The thoracic duct mostly ascended from the cisterna chili medial to the right diaphragmatic crus at the level of T12~L2 (one exception at T10). The distance from the origin of thoracic duct to the origin right diaphragmatic crus was (74.63±38.30) mm. There were all kinds of links among the intestinal trunk, left and right lumbar trunks, thoracic duct, the azygos vein and the accessory azygos vein. ② The minimum distance from the thoracic duct to the azygos vein and the maximum distance from the thoracic duct to the hemiazygos vein and the accessory hemiazygos vein was at the level of T8, and the distance grew and shrunk with the rib level rising and lowering, respectively. Conclusions In the course of T5~10 the thoracic duct has a fixed and single trunk with fewer variations. It is easy to dissect thoracic duct below the azygos vein, above descending aorta in front of vertebral column through trans-right-thoracic approach during video-assisted thoracoscopic surgery (VATS), while through trans-left-thoracic approach it should be above the azygos vein and below descending aorta.
ZHANG Xiao-Wen , YANG Jie , LIU Wen-Guo , HUANG Feng , WANG Ti-Jian , ZHANG Bin , TUN Jiao-Lian , GU Wei-Quan , XIE Dun , WANG Fei . Applied anatomic study of video-assisted thoracoscopic ligation of thoracic duct[J]. Chinese Journal of Clinical Anatomy, 2014 , 32(3) : 264 -268 . DOI: 10.13418/j.issn.1001-165x.201
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