Department of Anatomical Sciences, St George's University, True Blue, Grenada.
Department of Anatomy, Varmia and Mazury Medical School, Olsztyn, Poland.
Clin Anat. 2022 Oct;35(7):998-1006. doi: 10.1002/ca.23894. Epub 2022 May 12.
Patients with pancreatic cancer, chronic pancreatitis and other abdominal pain syndromes may develop debilitating pain throughout the course of their illness with little to no relief by most conventional methods. While some form of relief is experienced by patients, not all benefit from these procedures and side effects, while transitory in most cases are severe and often not expected. Our aim was therefore to investigate the anatomy surrounding the abdominal sympathetic ganglia, the target for the invasive procedures in an attempt to understand the variations in results.
The abdominal cavities of nine individuals were dissected and the ganglia investigated, harvested and histologically and immunochemical stained.
The phrenic ganglion was found inconsistently and more often in the left than the right. If present it was located in association with the inferior phrenic artery and often connected to the celiac ganglion. The celiac ganglion was located anterior to the diaphragmatic crus on both sides and specifically posteromedial to the suprarenal gland and superior to the renal artery on the left. On the right it was located posterior to the suprarenal gland and inferior vena cava also superior to the renal vessels. The superior mesenteric ganglion was only positively identified in one individual and was located on the left lateral aspect of the superior mesenteric artery.
The blockade procedures for treatment of pain are developed to target the area around the celiac artery where the ganglion is commonly described to be located. However, based on our results of its location and interconnections the ganglion is not located in the targeted area.
患有胰腺癌、慢性胰腺炎和其他腹痛综合征的患者在疾病过程中可能会出现衰弱性疼痛，而大多数常规方法几乎无法缓解这种疼痛。虽然患者会有某种形式的缓解，但并非所有患者都能从这些手术中受益，而且这些手术的副作用虽然在大多数情况下是暂时的，但却很严重，而且往往是出乎意料的。因此，我们的目的是研究腹部交感神经节周围的解剖结构，即侵袭性手术的目标，试图了解结果的变化。
对 9 个人的腹腔进行解剖，研究、采集神经节，并进行组织学和免疫化学染色。
膈神经节的发现不一致，左侧比右侧更常见。如果存在，它位于下膈动脉附近，通常与腹腔神经节相连。腹腔神经节位于两侧膈脚前方，肾上腺内侧，左肾动脉上方。在右侧，它位于肾上腺和下腔静脉后方，也在肾血管上方。肠系膜上神经节仅在 1 个人中被明确识别，位于肠系膜上动脉的左侧。
用于治疗疼痛的阻滞手术是针对腹主动脉周围区域进行的，通常认为神经节位于该区域。然而，根据我们对其位置和相互连接的研究结果，神经节并不位于目标区域。
