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Histological study of the thin membranous dense connective tissue around the middle and lower thoracic esophagus, caudal to the bifurcation of the trachea

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A Correction to this article was published on 03 April 2021

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Abstract

Objective

We previously reported on the thin membranous dense connective tissue around the esophagus in the upper mediastinum. This time, we histologically investigated the existence of similar structures in the middle and lower mediastinum, caudal to the bifurcation of the trachea.

Methods

Semi-sequential transverse sections of the mediastinum were obtained from two cadavers. Hematoxylin and eosin staining and Elastica van Gieson staining were performed.

Results

In the middle mediastinum, the “visceral sheath” could not be observed completely around the esophagus. In the lower mediastinum, the thin membranous dense connective tissue was observed beneath the pericardium on the ventral side of the esophagus. On the dorsal side of the esophagus, two thin membranous dense connective tissues were similarly observed in two cadavers. One existed between the dorsal side of the esophagus and the three vessels (i.e., the descending aorta, the azygos vein and the thoracic duct) and was integrated with the thin membranous dense connective tissue of the ventral side of the esophagus at the bilateral side of the esophagus. This integrated dense connective tissue reached the left subpleural region and the adventitia of the aorta on the left side and the peripleural and pulmonary hilum on the right side. The other thin membranous dense connective tissue, which represents the “vascular sheath”, was observed between the descending aorta and the thoracic duct.

Conclusion

These two thin membranous dense connective tissues, which are considered to represent the visceral sheath and vascular sheath, are thought to be available as optimal dissecting layers for radical esophagectomy.

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Acknowledgements

We thank Ms. Yoko Takagi for her technical assistance in performing histological staining and Dr. Kumiko Yamaguchi for providing technical support in anatomical procedure.

Funding

This work was partly supported by JSPS KAKENHI Grant Number 20K09002.

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Authors and Affiliations

  1. Department of Surgery, Toshima Hospital Tokyo Metropolitan Health and Hospitals Corporation, Tokyo, 173-0015, Japan

    Yutaka Tokairin & Yudai Kawamura

  2. Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Yutaka Tokairin, Kagami Nagai, Yudai Kawamura, Yasuaki Nakajima, Kenro Kawada, Akihiro Hoshino, Takuya Okada & Yusuke Kinugasa

  3. Department of Clinical Anatomy, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Satoru Muro & Keiichi Akita

Authors
  1. Yutaka Tokairin
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  2. Kagami Nagai
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  3. Yudai Kawamura
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  4. Yasuaki Nakajima
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  5. Kenro Kawada
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  6. Akihiro Hoshino
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  7. Takuya Okada
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  8. Satoru Muro
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  9. Keiichi Akita
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  10. Yusuke Kinugasa
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Correspondence to Yutaka Tokairin.

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The authors declare no conflicts of interest in association with the present study.

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Tokairin, Y., Nagai, K., Kawamura, Y. et al. Histological study of the thin membranous dense connective tissue around the middle and lower thoracic esophagus, caudal to the bifurcation of the trachea. Gen Thorac Cardiovasc Surg 69, 983–992 (2021). https://doi.org/10.1007/s11748-021-01615-3

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