Biondi Alberto, Rausei Stefano, Cananzi Ferdinando C M, Zoccali Marco, D'Ugo Stefano, Persiani Roberto
Unita Operativa di Chirurgia Generale 1, Policlinico A. Gemelli, Istituto di Patologia Speciale Chirurgica, Università Cattolica del Sacro Cuore, Roma, Largo A. Gemelli 8, 00167, Roma.
Ann Ital Chir. 2007 Sep-Oct;78(5):351-3.
The mediastinum is located from the thoracic inlet to the diaphragm between the left and right pleural cavities and contains vital structures of the circulatory, respiratory, digestive, and nervous system. Over the years, since there are no fascial or anatomic planes, anatomists and radiologists have suggested various schemes for subdividing the mediastinum and several anatomical and radiological classifications of the mediastinum are reported in the literature. The most popular of these scheme divides medistinum, for purposes of description, into two parts: an upper portion, above the upper level of the pericardium, which is named the superior mediastinum; and a lower portion, below the upper level of the pericardium. For clinical purposes, the mediastinum may be subdivided into three major areas, i.e. anterior, middle, and posterior compartments. The anterior mediastinum is defined as the region posterior to the sternum and anterior to the heart and brachiocephalic vessels. It extends from the thoracic inlet to the diaphragm and contains the thymus gland, fat, and lymph nodes. This article will review surgical anatomy of the anterior mediastinum and will focus on the surgical approch to anterior mediastinum and thymic diseases.
纵隔位于胸廓入口至膈肌之间，左右胸膜腔之间，包含循环、呼吸、消化和神经系统的重要结构。多年来，由于不存在筋膜或解剖平面，解剖学家和放射学家提出了各种纵隔细分方案，文献中报道了几种纵隔的解剖学和放射学分类。其中最常用的方案是，为了便于描述，将纵隔分为两部分：心包上缘以上的上部，称为上纵隔；心包上缘以下的下部。出于临床目的，纵隔可细分为三个主要区域，即前纵隔、中纵隔和后纵隔。前纵隔定义为胸骨后方、心脏和头臂血管前方的区域。它从胸廓入口延伸至膈肌，包含胸腺、脂肪和淋巴结。本文将回顾前纵隔的手术解剖，并重点关注前纵隔和胸腺疾病的手术入路。
