Le Pimpec Barthes F, Riquet M, Hartl D, Hubsch J P, Hidden G
Service de Chirurgie Thoracique - Hôpital Laennec (Paris).
Bull Assoc Anat (Nancy). 1996 Jun;80(249):11-6.
The aim of this study was to describe in detail the anastomoses between pulmonary lymphatic vessels and veins of the neck so as to better understand certain complications in thoracic surgery. Lymphatic vessels of 687 pulmonary segments in 360 cadavers were injected. Detailed study of the end of the right paratracheal, right thoraco oesophageal, left preaorticocarotid and left recurrent lymph node chains was undertaken. The results showed the absence of any major right lymphatic duct. There were, however, many lymphatic arches draining into the jugulo-subclavian confluent ipsilaterally and, in 10 to 25% of cases, contralaterally, as well. The intertracheobronchial lymph nodes also drained into the venous confluents of the neck, via direct lymphatic vessels, without lymph node relays. Lastly, the left mediastinal lymph node chains were frequently found to drain into the arch of the thoracic duct (40% of cases), and reflux by valvular incompetence at this level could be an explanation for chylous pericarditis and some chylothoraxes after surgery.
本研究的目的是详细描述肺淋巴管与颈部静脉之间的吻合情况，以便更好地理解胸外科手术中的某些并发症。对360具尸体的687个肺段的淋巴管进行了注射。对右气管旁、右胸段食管、左主动脉前颈动脉和左喉返淋巴结链的末端进行了详细研究。结果显示不存在任何主要的右淋巴管。然而，有许多淋巴弓同侧引流至颈内静脉与锁骨下静脉汇合处，在10%至25%的病例中，对侧也有引流。气管支气管间淋巴结也通过直接淋巴管引流至颈部静脉汇合处，无淋巴结中转。最后，经常发现左纵隔淋巴结链引流至胸导管弓（40%的病例），该水平的瓣膜功能不全导致的反流可能是术后乳糜性心包炎和一些乳糜胸的原因。
