ANATOMIC STUDY OF THE BRONCHIAL ARTERIES WITH SPECIAL REFERENCE TO THEIR PRESERVATION DURING THE RADICAL DISSECTION OF THE UPPER MEDIASTINUM LYMPH-NODES

Background. The anatomy of the bronchial arteries was studied with spe cial reference to their preservation during the radical dissection of the upper mediastinum lymph nodes. Methods. The bronchial arteries of 71 cadavers were studied macroscopically by use of the surgical field of right thoracotomy. The small branches difficult to identify macrosc opically were described by x-ray imaging with digital subtraction angi ography. Their anatomic relationship to the adjacent organs was observ ed microscopically. Results. The bronchial arteries arising from the i ntercostal arteries (the intercostobronchial arteries) were observed i n 66 of 71 cases. By use of the surgical field of light thoracotomy th e intercostobronchial arteries were easily found and preserved. All ca davers also had other bronchial arteries arising from the aorta. These were difficult to preserve because of the depth of the surgical field and the location of their course in the dissected area. Bronchial art eries had established connection with each other via the vascular netw ork in the tracheal proper sheath. India Ink injected into the interco stobronchial arteries was observed in the tracheal proper sheath and t he submucosa of the trachea. Conclusions. Saving the blood supply to t he trachea is possible with careful preservation of the intercostobron chial arteries and the tracheal proper sheath during radical dissectio n of the upper mediastinum.