1
|
Lhuaire M, Wavreille G, Hivelin M, Aumar A, Hunsinger V, Derder M, Lellouch AG, Abrahams P, Lantieri L, Fontaine C. Journal of Plastic, Reconstructive and Aesthetic Surgery Venous system mapping of the digits and the hand: an anatomical study and potential surgical applications. JPRAS Open 2022; 33:171-183. [PMID: 36051780 PMCID: PMC9424264 DOI: 10.1016/j.jpra.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 04/21/2022] [Indexed: 12/01/2022] Open
Abstract
Background Venous anatomy of the digits and the hand is poorly reported in the literature compared to arterial anatomy. While knowledge of the venous anatomy is crucial to ensure safe skin incisions, skin flap design, or blood return restoration for digital replantations, data in anatomical and clinical textbooks are rather limited. The purpose of this anatomical study was to describe the venous anatomy of the digits and the hand. Method Our series reports descriptive results from 10 non-embalmed hand dissections from 5 different corpses. Hands were previously co-injected by arteries followed by veins with a different colored latex before being dissected under optical magnification (x4). Each anatomical specimen was photographed before being analyzed. Results Each injection revealed both arterial and venous vascular systems. Latex injections were a useful technique to show the dorsal, volar superficial, and deep venous system. There was a constant and reliable topographic vascular anatomy of the superficial venous system of the digits and hand. However, we could not observe a high density of dorsal superficial venous valves as previously reported. Conclusion The knowledge of the arrangement of the venous system of the digits and the hand should help the surgeon when performing surgical procedures in the hand. The surgeon should take into consideration this venous anatomy when performing skin incisions, skin flaps, or replantation procedures which would preserve the normal venous physiology as much as possible.
Collapse
Affiliation(s)
- Martin Lhuaire
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France
- Institute of Anatomy and Organogenesis, Faculté de Médecine Henri Warembourg, Université de Lille, Lille, France
- SOS Hands and Fingers, Clinique Lille Sud, Lesquin, France
- Correspondence to: Dr Martin LHUAIRE, Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, 20 rue Leblanc, 75908, Paris Cedex 15, France. Tel: +33 1 56 09 58 71.
| | | | - Mikael Hivelin
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Ambroise Paré, Assistance Publique des Hôpitaux de Paris, Université Paris-Saclay, Paris, France
| | - Aurélien Aumar
- SOS Hands and Fingers, Clinique Lille Sud, Lesquin, France
| | - Vincent Hunsinger
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France
| | - Mohamed Derder
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France
| | - Alexandre G. Lellouch
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France
- Vascularized Composite Allotransplantation Laboratory, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Peter Abrahams
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Laurent Lantieri
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université de Paris, Paris, France
| | - Christian Fontaine
- Institute of Anatomy and Organogenesis, Faculté de Médecine Henri Warembourg, Université de Lille, Lille, France
| |
Collapse
|
2
|
Shankar S, Rammohan A, Rela M, Srinivasan P. Surgical anatomy of segment four of liver and its implications in hepato-biliary surgery and liver transplantation. Journal of Liver Transplantation 2022. [DOI: 10.1016/j.liver.2022.100076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
3
|
Lhuaire M, Wehbe K, Garrido I, Hunsinger V, Derder M, Balaya V, Delmas V, Abrahams P, Sommacale D, Kianmanesh R, Fontaine C, Lantieri L. Anatomy of the axillary arch: from its incidence in human to an embryologic and a phylogenetic explanation of its origins. Surg Radiol Anat 2021; 43:619-30. [PMID: 33136183 DOI: 10.1007/s00276-020-02605-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Typically, the axillary arch is defined as a fleshy slip running from latissimus dorsi to the anterior aspect of the humerus. Phylogeny seems to give the most relevant and plausible explanation of this anatomical variant as a remnant of the panniculus carnosus. However, authors are not unanimous about its origin. We report herein the incidence of axillary arch in a series of 40 human female dissections and present an embryologic and a comparative study in three domestic mammals. MATERIALS AND METHODS Forty formalin-preserved Caucasian human female cadavers, one rat (Rattus norvegicus), one rabbit (Oryctolagus cuniculus) and one pig (Sus scrofa domesticus) cadavers were dissected bilaterally. A comparative, analytical and a descriptive studies of serial human embryological sections were carried out. RESULTS We found an incidence of axillary arch of 2.5% (n = 1 subject of 40) in Humans. We found a panniculus carnosus inserted on the anterior aspect of the humerus only in the rat and the rabbit but not in the pig. The development of the latissimus dorsi takes place between Carnegie stage 16-23, but the embryological study failed to explain the genesis of the axillary arch variation. However, comparative anatomy argues in favour of a panniculus carnosus origin of the axillary arch. CONCLUSIONS With an incidence of 2.5% of cases, the axillary arch is a relatively frequent variant that should be known by clinician and especially surgeons. Moreover, while embryology seems to fail to explain the genesis of this variation, comparative study gives additional arguments which suggest a possible origin from the panniculus carnosus.
Collapse
|
4
|
Yang B, Si G, He Q, Liu S, Wang S, Xian R, Zhang J, Yu F, Guan J. Multislice Computed Tomographic Manifestation of Transient Hepatic Attenuation Difference in the Left Lobe of the Liver: A Retrospective Study. Adv Ther 2020; 37:3954-3966. [PMID: 32715380 DOI: 10.1007/s12325-020-01428-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Transient hepatic attenuation differences (THAD) are areas of high parenchymal enhancement observed during the hepatic arterial phase on computed tomography (CT). THAD in the left lobe of the liver can lead to surgical complications. METHODS A retrospective study was conducted on patients who underwent multislice computed tomography (MSCT) examination of the upper abdomen to understand the morphology, distribution, and causes of THAD and their correlation with hepatic artery variation. RESULTS Among 179 cases, 65 and 114 belonged to diseased and normal groups, respectively. THAD as observed in MSCT demonstrated various shapes: lobe/segment (127 cases; 70.9%), irregular sheet (31; 17.3%), strip shape (9; 5.02%), arc/semicircle (7; 3.9%), and segment + flaky (5; 2.79%). THAD were found to be caused by liver tumor (32.3%), hepatic inflammatory lesions (6.15%), biliary tract diseases (13.8%), perihepatic disease compression (9.23%), portal vein obstructive disease (1.53%), and lesion in left hepatic lobe with hepatic artery variation (29.2%). THAD exhibited variation in distribution in the left lobe of the liver. Among 114 cases, THAD in 18 (15.7%) cases were observed in the S2 segment, six (5.26%) in the S3 segment, and 90 (78.9%) in multiple segments of the liver, that is, 50 cases in S2 and S3 segments and 40 cases in S2, S3, and S4 segments. The hepatic artery of 179 cases was of various types based on Hiatt classification: 57 cases of Hiatt I (31%), 65 cases of Hiatt II (37%), 11 cases of Hiatt III (6%), 17 cases of Hiatt IV (10%), 7 cases of Hiatt V (4%), 12 cases of large left hepatic artery (7%), 6 cases of right hepatic artery originating from the celiac trunk (3%), and 4 cases (2%) of superior mesenteric artery originating from the celiac trunk. CONCLUSION THAD can occur as a result of specific pathological causes and hence should be considered as a diagnostic sign in liver pathologies.
Collapse
Affiliation(s)
- Bin Yang
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Guangyan Si
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China.
| | - Qizhou He
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Shulan Liu
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Sikai Wang
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Rong Xian
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Jie Zhang
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Fei Yu
- Department of Radiology, Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Lu Zhou, 646000, Sichuan, People's Republic of China
| | - Jian Guan
- Department of Radiology, The First Affiliated Hospital of Zhongshan University, Guang Zhou, 510080, Guangdong, People's Republic of China
| |
Collapse
|
5
|
Chijimatsu R, Saito T. Mechanisms of synovial joint and articular cartilage development. Cell Mol Life Sci 2019; 76:3939-3952. [PMID: 31201464 DOI: 10.1007/s00018-019-03191-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/30/2019] [Accepted: 06/11/2019] [Indexed: 12/29/2022]
Abstract
Articular cartilage is formed at the end of epiphyses in the synovial joint cavity and permanently contributes to the smooth movement of synovial joints. Most skeletal elements develop from transient cartilage by a biological process known as endochondral ossification. Accumulating evidence indicates that articular and growth plate cartilage are derived from different cell sources and that different molecules and signaling pathways regulate these two kinds of cartilage. As the first sign of joint development, the interzone emerges at the presumptive joint site within a pre-cartilage tissue. After that, joint cavitation occurs in the center of the interzone, and the cells in the interzone and its surroundings gradually form articular cartilage and the synovial joint. During joint development, the interzone cells continuously migrate out to the epiphyseal cartilage and the surrounding cells influx into the joint region. These complicated phenomena are regulated by various molecules and signaling pathways, including GDF5, Wnt, IHH, PTHrP, BMP, TGF-β, and FGF. Here, we summarize current literature and discuss the molecular mechanisms underlying joint formation and articular development.
Collapse
Affiliation(s)
- Ryota Chijimatsu
- Bone and Cartilage Regenerative Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Taku Saito
- Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| |
Collapse
|
6
|
Lhuaire M, Hivelin M, Derder M, Hunsinger V, Delmas V, Abrahams P, Sommacale D, Kianmanesh R, Fontaine C, Lantieri L. Anatomical variations of the subscapular pedicle and its terminal branches: an anatomical study and a reappraisal in the light of current surgical approaches. Surg Radiol Anat 2018; 41:385-392. [PMID: 30547208 DOI: 10.1007/s00276-018-2161-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 12/08/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE While anatomical variations of the subscapular vessels are frequently encountered during axillary dissection, little is found in the literature. The aim of this cadaveric study was to define arterial and venous anatomical variations and frequencies of the subscapular vascular pedicle and its terminal/afferent vessels in women. METHODS We performed 80 dissections of the axillary region on forty female formalin-embalmed cadavers. Each anatomical arrangement was photographed and recorded on a scheme before analysis. RESULTS We propose a new classification of the subscapular pedicle variations. We observed three types of subscapular arterial variation. The type Ia was the most frequent arrangement (71% of our dissections), the type Ib was observed in 11% and the type II in 18% of cases. We observed four types of subscapular venous variation. The type Ia was observed in 63% of cases, the type Ib in 14%, the type II in 14% and the type III in 10% of cases. CONCLUSIONS This knowledge of the anatomical variation arrangement and frequencies of the subscapular vascular pedicle will assist the surgeon when dissecting the axillary region for malignant or reconstructive procedures.
Collapse
Affiliation(s)
- Martin Lhuaire
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes, Paris V, 20 rue Leblanc, 75908, Paris Cedex 15, France. .,Institute of Anatomy and Organogenesis, Faculté de Médecine Henri Warembourg, Université de Lille II, Lille, France. .,Department of General and Digestive Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France.
| | - Mikael Hivelin
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes, Paris V, 20 rue Leblanc, 75908, Paris Cedex 15, France
| | - Mohamed Derder
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes, Paris V, 20 rue Leblanc, 75908, Paris Cedex 15, France
| | - Vincent Hunsinger
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes, Paris V, 20 rue Leblanc, 75908, Paris Cedex 15, France
| | - Vincent Delmas
- Institute of Anatomy, URDIA, EA4465, UFR Biomédicale des Saints-Pères, Université Paris Descartes, Paris V, Paris, France
| | - Peter Abrahams
- Institute of Anatomy and Clinical Education, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Daniele Sommacale
- Department of General and Digestive Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France
| | - Reza Kianmanesh
- Department of General and Digestive Surgery, Hôpital Robert Debré, Centre Hospitalier Universitaire de Reims, Université de Reims Champagne-Ardenne, Reims, France
| | - Christian Fontaine
- Institute of Anatomy and Organogenesis, Faculté de Médecine Henri Warembourg, Université de Lille II, Lille, France
| | - Laurent Lantieri
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Université Paris Descartes, Paris V, 20 rue Leblanc, 75908, Paris Cedex 15, France
| |
Collapse
|
7
|
Hikspoors JPJM, Peeters MMJP, Kruepunga N, Mekonen HK, Mommen GMC, Köhler SE, Lamers WH. Human liver segments: role of cryptic liver lobes and vascular physiology in the development of liver veins and left-right asymmetry. Sci Rep 2017; 7:17109. [PMID: 29214994 PMCID: PMC5719430 DOI: 10.1038/s41598-017-16840-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 11/16/2017] [Indexed: 12/15/2022] Open
Abstract
Couinaud based his well-known subdivision of the liver into (surgical) segments on the branching order of portal veins and the location of hepatic veins. However, both segment boundaries and number remain controversial due to an incomplete understanding of the role of liver lobes and vascular physiology on hepatic venous development. Human embryonic livers (5-10 weeks of development) were visualized with Amira 3D-reconstruction and Cinema 4D-remodeling software. Starting at 5 weeks, the portal and umbilical veins sprouted portal-vein branches that, at 6.5 weeks, had been pruned to 3 main branches in the right hemi-liver, whereas all (>10) persisted in the left hemi-liver. The asymmetric branching pattern of the umbilical vein resembled that of a "distributing" vessel, whereas the more symmetric branching of the portal trunk resembled a "delivering" vessel. At 6 weeks, 3-4 main hepatic-vein outlets drained into the inferior caval vein, of which that draining the caudate lobe formed the intrahepatic portion of the caval vein. More peripherally, 5-6 major tributaries drained both dorsolateral regions and the left and right ventromedial regions, implying a "crypto-lobar" distribution. Lobar boundaries, even in non-lobated human livers, and functional vascular requirements account for the predictable topography and branching pattern of the liver veins, respectively.
Collapse
Affiliation(s)
- Jill P J M Hikspoors
- Department of Anatomy & Embryology, Maastricht University, Maastricht, The Netherlands
| | - Mathijs M J P Peeters
- Department of Anatomy & Embryology, Maastricht University, Maastricht, The Netherlands
| | - Nutmethee Kruepunga
- Department of Anatomy & Embryology, Maastricht University, Maastricht, The Netherlands
- Department of Anatomy, Faculty of Science, Mahidol University, Rama VI Road, Bangkok, 10400, Thailand
| | - Hayelom K Mekonen
- Department of Anatomy & Embryology, Maastricht University, Maastricht, The Netherlands
| | - Greet M C Mommen
- Department of Anatomy & Embryology, Maastricht University, Maastricht, The Netherlands
| | - S Eleonore Köhler
- Department of Anatomy & Embryology, Maastricht University, Maastricht, The Netherlands
- NUTRIM Research School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Wouter H Lamers
- Department of Anatomy & Embryology, Maastricht University, Maastricht, The Netherlands.
- Tytgat Institute for Liver and Intestinal research, Academic Medical Center, Amsterdam, The Netherlands.
| |
Collapse
|