Evidence map›Paper›PMID 37555123›Full record

ArticleWorld journal of gastrointestinal surgery2023

Histological study of the structural layers around the esophagus in the lower mediastinum.

Toshifumi Saito, Satoru Muro, Hisashi Fujiwara, Yuya Umebayashi, Yuya Sato, Masanori Tokunaga, Keiichi Akita, Yusuke Kinugasa

Abstract read
In one paragraph

Article in World journal of gastrointestinal surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Toshifumi SaitoDepartment of Gastrointestinal Surgery, Tokyo Medical and Dental University, Bunkyo-ku 113-8519, Tokyo, Japan.
Satoru MuroDepartment of Clinical Anatomy, Tokyo Medical and Dental University, Bunkyo-ku 113-8519, Tokyo, Japan.
Hisashi FujiwaraDepartment of Gastrointestinal Surgery, Tokyo Medical and Dental University, Bunkyo-ku 113-8519, Tokyo, Japan. fujsrg1@tmd.ac.jp.
Yuya UmebayashiDepartment of Gastrointestinal Surgery, Tokyo Medical and Dental University, Bunkyo-ku 113-8519, Tokyo, Japan.
Yuya SatoDepartment of Gastrointestinal Surgery, Tokyo Medical and Dental University, Bunkyo-ku 113-8519, Tokyo, Japan.
Masanori TokunagaDepartment of Gastrointestinal Surgery, Tokyo Medical and Dental University, Bunkyo-ku 113-8519, Tokyo, Japan.
Keiichi AkitaDepartment of Clinical Anatomy, Tokyo Medical and Dental University, Bunkyo-ku 113-8519, Tokyo, Japan.
Yusuke KinugasaDepartment of Gastrointestinal Surgery, Tokyo Medical and Dental University, Bunkyo-ku 113-8519, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Japan, the transhiatal approach, including lower mediastinal lymph node dissection, is widely performed for Siewert type II esophagogastric junction adenocarcinoma. This procedure is generally performed in a magnified view using laparoscopy or a robotic system, therefore, the microanatomy of the lower mediastinum is important. However, mediastinal microanatomy is still unclear and classification of lower mediastinal lymph nodes is not currently based on fascia or other microanatomical structures.

aimTo clarify the fascia and layer structures of the lower mediastinum and classify the lower mediastinal tissue.

methodsWe dissected the esophagus and surrounding organs

resultsWe identified two fasciae, A and B. We then classified lower mediastinal tissue into three areas, paraesophageal, paraaortic, and intermediate, using these fasciae as boundaries. Lymph nodes were found to be present and were counted in each area. The dorsal part of the intermediate area was thicker on the caudal side than on the cranial side in all cadavers. On the dorsal side, no blood vessels penetrated the fasciae in six of the seven cadavers, whereas the proper esophageal artery penetrated fascia B in one cadaver. D2-40 immunostaining showed lymphatic vessel connections between the paraesophageal and intermediate areas on the lateral and ventral sides of the esophagus, but no lymphatic connection between areas on the dorsal side of the esophagus.

conclusionHistological studies identified two fasciae surrounding the esophagus in the lower mediastinum and the layers separated by these fasciae were used to classify the lower mediastinal tissues.

Indexed as

AdenocarcinomaEsophageal cancerEsophagogastric junctionGastric cancerHistologyMediastinum

Identifiers

PMID37555123
PMCPMC10405116

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