Option of different path for full-length phrenic nerve transfer: an anatomic study

Objective To study the surgical path of full length phrenic nerve transfer anatomically, and to set up the basis on harvesting the full length phrenic nerve under TV thoracoscope. Methods 10 fresh cadavers (20 sides)were studied. Two kinds of method, phrenic nerve transferred supraclavicularly and infraclavicularly, were compared. Results When the phrenic nerve was harvested supraclavicularly, the distal end to the middle point of clavicle could reach 11.45±1.64 cm on the right side and 19.1±1.42 cm on the left side. The supplying vessels could not be accompanied at both sides. When the phrenic nerve was taken out infraclavicularly, the end could reach 6.4 ±0.74 cm on the right side and 11.7±1.5 cm on the left side. The accompanied vessels could be harvested together at both sides. Conclusions There were advantages and disadvantages between the two procedures. For the supraclavicular transfer, the length of the phrenic nerve can be cut longer, but the accompanied vessels could not be taken out together and the exposure was extensive. On the other hand, a pedicel phrenic nerve transfer could be accomplished together with the pericardiocophrenic vessels by subclavicular method, though the length of the phrenic nerve was shorter.