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Xiao W, Long X, Chen J, Tan Y, Cheng X, Gong L, Qiu X, Ma T, Bai Y, Li C. Computed tomographic manifestations of celiac ganglia between hypertensive and non-hypertensive population. J Clin Hypertens (Greenwich) 2023; 25:853-860. [PMID: 37559357 PMCID: PMC10497025 DOI: 10.1111/jch.14706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/05/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023]
Abstract
The celiac ganglion (CG) is associated with the sympathetic nervous system (SNS) and plays an important role in the pathogenesis of hypertension. The characteristics of the CG in patients with hypertension remain unknown. The aim of our study was to explore the differences in celiac ganglia (CGs) characteristics between hypertensive and non-hypertensive populations using computed tomography (CT). CGs manifestations on multidetector row CT in 1003 patients with and without hypertension were retrospectively analyzed. The morphological characteristics and CT values of the left CGs were recorded. The CT values of the ipsilateral adrenal gland (AG) and crus of the diaphragm (CD) were also measured. The left CG was located between the left AG and CD, and most CGs were long strips. The frequency of visualization of the left CGs was higher in the hypertension group than in the non-hypertension group (p < .05). There were no significant differences in the maximum diameter, size, and shape ratio of the left CGs between the two groups (p > .05). Except for the left CG in the arterial phase, the CT values of the left CG and AG in the non-hypertensive group were higher than those in the hypertension group (p < .05). The venous phase enhancement of the left CG in the non-hypertension group was significantly higher than that in the hypertension group (p < .05). Our findings reveal that CGs have characteristic manifestations in the hypertensive population. As important targets of the SNS, CGs have the potential to regulate blood pressure.
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Affiliation(s)
- Wenkai Xiao
- Department of Geriatrics MedicineCenter of Coronary CirculationXiangya HospitalCentral South UniversityChangshaChina
| | - Xueying Long
- Department of RadiologyXiangya HospitalCentral South UniversityChangshaChina
| | - Junyu Chen
- Department of Geriatrics MedicineCenter of Coronary CirculationXiangya HospitalCentral South UniversityChangshaChina
| | - Yu Tan
- Department of Geriatrics MedicineCenter of Coronary CirculationXiangya HospitalCentral South UniversityChangshaChina
| | - Xunjie Cheng
- Department of Geriatrics MedicineCenter of Coronary CirculationXiangya HospitalCentral South UniversityChangshaChina
| | - Li Gong
- Department of Geriatrics MedicineCenter of Coronary CirculationXiangya HospitalCentral South UniversityChangshaChina
| | - Xueting Qiu
- Department of Geriatrics MedicineCenter of Coronary CirculationXiangya HospitalCentral South UniversityChangshaChina
| | - Tianqi Ma
- Department of Geriatrics MedicineCenter of Coronary CirculationXiangya HospitalCentral South UniversityChangshaChina
| | - Yongping Bai
- Department of Geriatrics MedicineCenter of Coronary CirculationXiangya HospitalCentral South UniversityChangshaChina
| | - Chuanchang Li
- Department of Geriatrics MedicineCenter of Coronary CirculationXiangya HospitalCentral South UniversityChangshaChina
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Hong Z, Wu X, Sheng Y, Cui B, Bai X, Lu Y, Cheng T, Jin D, Gou Y. Comparison of the efficacy of ETS with different segments for palmar, axillary and plantar hyperhidrosis. BMC Surg 2023; 23:82. [PMID: 37041509 PMCID: PMC10091614 DOI: 10.1186/s12893-023-01976-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 03/28/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND To compare the near and long-term outcomes of endoscopic thoracic sympathectomy (ETS) for palmar, axillary and plantar hyperhidrosis. METHODS We retrospectively analyzed the clinical data of 218 patients with hyperhidrosis who were admitted to the Department of Thoracic Surgery of Gansu Provincial People's Hospital for surgical treatment from April 2014 to August 2021. The patients were divided into three groups according to the method of ETS and the perioperative clinical data and postoperative follow-up data were collected to compare the near and long term outcomes of the three groups. RESULTS There were 197 eligible patients at follow-up, 60 patients in the R4 cut-off group, 95 patients in the R3 + R4 cut-off group and 42 patients in the R4 + R5 cut-off group. There were no statistically significant differences in baseline indicators such as sex, age and positive family history among the three groups (P > 0.05). There was no statistically significant difference between the three groups in terms of operative time (P = 0.148), intraoperative bleeding (P = 0.308) and postoperative hospital stay (P = 0.407). Postoperatively, all three groups showed significant relief of palmar hyperhidrosis symptoms, with the R3 + R4 group having an advantage in terms of relief of axillary hyperhidrosis symptoms, patient satisfaction and quality of life index at 6 months postoperatively and the R4 + R5 group having an advantage in terms of relief of plantar hyperhidrosis symptoms. The difference in compensatory hyperhidrosis at 12 months postoperatively was not statistically significant among the three groups (P = 0.867), but the incidence was higher in the R3 + R4 and R4 + R5 groups than that in the R4 group. CONCLUSION Patients with simple palmar hyperhidrosis can first consider R4 cut-off treatment; R3 + R4 cut-off is more effective in treating palmar hyperhidrosis combined with axillary hyperhidrosis; R4 + R5 cut-off is more effective in treating palmar hyperhidrosis combined with plantar hyperhidrosis. However, patients need to be informed that R3 + R4 and R4 + R5 dissection may increase the risk of severe compensatory hyperhidrosis after surgery.
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Affiliation(s)
- Ziqiang Hong
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Xusheng Wu
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Yannan Sheng
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
| | - Baiqiang Cui
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Xiangdou Bai
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Yingjie Lu
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
| | - Tao Cheng
- The First Clinical Medical College of Gansu, University of Traditional Chinese Medicine, 35 East Dingxi Road, Lanzhou, Gansu, 730000, China
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Dacheng Jin
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China
| | - Yunjiu Gou
- First Department of Thoracic Surgery, Gansu Provincial Hospital, 204 Donggang West Road, Lanzhou, Gansu, 730000, China.
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Peetermans M, Vanlommel J, Van Look L, Uyttebroek L, Van Schil P, van Nassauw L. The anatomical variations of the additional communicating rami in the proximal sympathetic trunk: A human cadaveric study. TRANSLATIONAL RESEARCH IN ANATOMY 2023. [DOI: 10.1016/j.tria.2023.100240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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Vanlommel J, Van Look L, Peetermans M, Uyttebroek L, van Nassauw L, Van Schil P. Anatomical variations of the upper thoracic sympathetic chain: a review. Eur J Cardiothorac Surg 2021; 61:515-522. [PMID: 34676399 DOI: 10.1093/ejcts/ezab445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/09/2021] [Accepted: 09/19/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The objective of this study is to provide a thorough overview of the anatomical variations of the upper thoracic sympathetic trunk to improve clinical results of upper thoracic sympathectomy. In addition, this study strives for standardization of future studies regarding the anatomy of the upper thoracic sympathetic chain. METHODS The Web of Science, PubMed and Google Scholar databases were searched using keywords, alone or combined, regarding the anatomy of the thoracic sympathetic chain. The search was limited to studies performed in humans. RESULTS Fifteen studies were finally included. Cervicothoracic ganglion and nerve of Kuntz were present in 77% and 53%, respectively. The upper thoracic ganglia were predominantly located in their corresponding intercostal space with a relatively downwards shift at the lower thoracic levels. The right sympathetic trunk is prone to have more communicating rami then the left. The lower levels of ganglia tend to have more normal rami. No clear pattern was found concerning the presence of the ascending rami and there was a decrease in the number of descending rami as the chain runs caudally. The intercostal rami remain a rare anatomical variation. CONCLUSIONS This study presents an overview of the anatomy of the upper thoracic sympathetic chain. Its results may guide upper thoracic sympathectomy to improve clinical results. This review also provides a baseline for future studies on anatomical variations of the thoracic sympathetic trunk. More uniform reporting is necessary to compare different anatomical studies.
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Affiliation(s)
- Jens Vanlommel
- Department ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Lawrence Van Look
- Department ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Maxime Peetermans
- Department ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Leen Uyttebroek
- Department ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Luc van Nassauw
- Department ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Paul Van Schil
- Department ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium
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