Applied anatomy of cutting the phrenic nerve under VATS

Objective:To provide anatomical basis for cutting the whole long phrenic nerve with which to repair the defect of brachial plexus under VATS.Methods:The phrenic nerves and neighboring organs on 12 sides of 6 fresh cadavers were carefully observed.Results:The pleura covered the phrenic nerve was loose and easy to be separated.The mean lengths of phrenic nerve from the lower edge of clavicle to its enter point of diaphragm were 16.50±2.17 cm on the right side and 23.00±2.50 cm on the left side.The blood supply of the phrenic nerve mainly came from the perocardiacophrenic artery whose mean diameter was 1.30±0.15 mm.The relationship of the phrenic nerve,the perocardiacophrenic artery and the internal thoracic artery wasn't constant on the region of thoracic inlet.Conclusion:The anatomical character of phrenic nerve made itself suitable to be cut under VATS.However,since the relationship of the phrenic nerve,the perocardiacophrenic artery and the internal thoracic artery wasn't constant on the region of thoracic inlet,the operation on this region was key part in the whole clinical operation.