title: [Vascular relationships of the right great splanchnic nerve in the thorax].
abstract: OBJECTIVE
  The surgical assumption of responsibility of the pancreatic pain requires either a truncular coelioscopic or radicular neurectomy of greater splanchnic nerves (gsn). The goal of our work is to describe the way and relations of the right gsn which are variable and rarely described. This constitutes an undeniable peroperational hemorrhagic risk during splanchnicectomy.
  
  
  METHODS
  After a double side thoracotomy and a bilateral sterno-clavicular desarticulation on 15 adult cadaveric subjects preserved by method of Winckler we removed the sterno-costal drill plate as well as the ventral rib arch and proceeded to a mediastinal evisceration of the thorax. Then we respected only the thoracic aorta and the oesophagus, the azygos venous system, the thoracic duct and the thoracic sympathetic chain. In some of the subjects, the azygos vein was injected (after catheterization of its stick) using gelatine coloured with blue paint. We studied the way and vascular relations of the right gsn. We measured the transverse distances between the origin of the gsn on one hand and the longitudinal axes of the azygos vein and the thoracic duct on the other hand.
  
  
  RESULTS
  The relations of the right gsn trunk during its way related to the azygos vein in particular its constitutive origin and its affluents: ascending lumbar vein and twelfth intercostal vein. Sometimes the thoracic duct even a lymphatic node was near the gsn in the posterior infra-mediastinal space. A classification of the way and vascular relations of the right gsn in the thorax identified 3 anatomical types. The average distances separating the right gsn on one hand from the azygos vein and the thoracic duct on the other hand were respectively 5.7 mm and 11.2 mm.
  
  
  CONCLUSIONS
  The vascular relations of the right gsn are very variable from one subject to another but primarily venous, sometimes lymphatic. They concerned the great thoracic vessels whose respect is essential in particular at the time of mini-invasive access procedure for a cœlioscopic splanchnicectomy.
authors.affiliation: Laboratoire d'anatomie, UFR de médecine, 1, rue Gaston-Veil, 44035 Nantes, France; Laboratoire d'anatomie et d'organogenèse, faculté de médecine, Dakar, Sénégal. Electronic address: jmndoye04@yahoo.fr.
authors.forename: J-M
authors.initials: JM
authors.lastname: Ndoye
authors.affiliation: Laboratoire d'anatomie, UFR de médecine, 1, rue Gaston-Veil, 44035 Nantes, France.
authors.forename: O
authors.initials: O
authors.lastname: Hamel
authors.affiliation: Laboratoire d'anatomie, UFR de médecine, 1, rue Gaston-Veil, 44035 Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Hamel
authors.affiliation: Laboratoire d'anatomie, UFR de médecine, 1, rue Gaston-Veil, 44035 Nantes, France.
authors.forename: S
authors.initials: S
authors.lastname: Ploteau
authors.affiliation: Laboratoire d'anatomie, UFR de médecine, 1, rue Gaston-Veil, 44035 Nantes, France.
authors.forename: O
authors.initials: O
authors.lastname: Armstrong
authors.affiliation: Laboratoire d'anatomie, UFR de médecine, 1, rue Gaston-Veil, 44035 Nantes, France.
authors.forename: J
authors.initials: J
authors.lastname: Le Borgne
authors.affiliation: Laboratoire d'anatomie, UFR de médecine, 1, rue Gaston-Veil, 44035 Nantes, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Rogez
authors.affiliation: Laboratoire d'anatomie, UFR de médecine, 1, rue Gaston-Veil, 44035 Nantes, France.
authors.forename: R
authors.initials: R
authors.lastname: Robert
mesh_terms: D015746:Abdominal Pain / Q000601:surgery*; D000328:Adult; D001013:Aorta, Thoracic / Q000033:anatomy & histology; D001401:Azygos Vein / Q000033:anatomy & histology*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002102:Cadaver; D006801:Humans; D008482:Mediastinum; D013153:Splanchnic Nerves / Q000033:anatomy & histology* / Q000601:surgery*; D013897:Thoracic Duct / Q000033:anatomy & histology; D013906:Thoracoscopy; D013908:Thoracotomy; D013909:Thorax / Q000098:blood supply* / Q000294:innervation*
keywords: Ascending lumbar vein; Azygos vein; Nerf grand splanchnique droit; Right great splanchnic nerve; Splanchnicectomie thoracoscopique; Thoracoscopic splanchnicectomy; Veine azygos; Veine lombaire ascendante