Morphometric characteristics of the abdominal surface of the diaphragm for various benefits

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Abstract

The dependence of the regional morphometric characteristics of the abdominal surface of the diaphragm on body shape was evaluated because the information available in the specialized literature on this issue differs significantly. The study was conducted on 30 corpses aged 50–70 years, who were embalmed using a special technology (preserving tissue elasticity, giving the diaphragm a physiological shape with deep exhalation by pumping air into the abdominal cavity). The objects were then frozen, abdominal organs were sequentially removed, and linear dimensions and areas of subdiaphragmatic, subhepatic, and splenic depressions, physiological openings (inferior vena cava, aorta, esophagus, and ligamentous apparatus of the upper floor of the peritoneal cavity), area nuda, diaphragm legs, and lumbar–rib triangles were examined. The results of the analysis of the morphometric parameters revealed significant statistically significant differences in the linear dimensions and areas of the right and left subdiaphragmatic, subhepatic, splenic depressions, and individual parts of the diaphragm in individuals with different body shapes. For these anatomical formations of the peritoneum, the highest values of morphometric parameters are characteristic of the brachymorphic form of the physique, except for the sizes of the lumbar–costal triangles, medial legs, and height of the diaphragm domes, which have the maximum dimensions with a dolichomorphic form. Attention was drawn to the significant differences in the area nuda between extreme forms of physique, which reached 59%. Statistically significant differences were found in the morphometric parameters of the abdominal surface of the diaphragm in mesomorphic and extreme forms of physique; however, they are characterized by smaller values, ranging from 8% to 42% for various parameters. Of particular importance is knowledge of the size of the studied parts of the diaphragm covered by the peritoneum during cytoreductive interventions. Anatomical studies performed on specially embalmed objects with preservation of tissue elasticity and the physiological shape of the diaphragm allow us to obtain its reliable morphometric characteristics.

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About the authors

Vadim A. Prosvetov

Kirov Military Medical Academy

Email: prosvetovvma@yandex.ru
ORCID iD: 0000-0002-5503-1598
SPIN-code: 1717-7735

external co-researcher

Russian Federation, Saint Petersburg

Ivan V. Gaivoronsy

Kirov Military Medical Academy; Saint Petersburg State University

Author for correspondence.
Email: i.v.gaivoronskiy@mail.ru
ORCID iD: 0000-0002-7232-6419
SPIN-code: 1898-3355

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Dmitry A. Surov

Kirov Military Medical Academy

Email: sda120675@mail.ru
SPIN-code: 5346-1613

MD, Dr. Sci. (Med.), associate Professor

Russian Federation, Saint Petersburg

Inga A. Goryacheva

Kirov Military Medical Academy; Saint Petersburg State University

Email: nichiporuk120@mail.ru
ORCID iD: 0000-0003-3064-7596
SPIN-code: 6705-8553

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg; Saint Petersburg

Pavel S. Panenko

Kirov Military Medical Academy

Email: pushercops@mail.ru
SPIN-code: 1035-3261

doctor of medical sciences, Professor

Russian Federation, Saint Petersburg

Oksana M. Fandeeva

Kirov Military Medical Academy

Email: osteolog_oxana@mail.ru
ORCID iD: 0000-0002-3857-7388
SPIN-code: 8320-9471

doctor of medical sciences

Russian Federation, Saint Petersburg

References

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  6. Prosvetov VA. Historical aspects of studying the anatomy of the diaphragm. Morphology at the turn of the century In: Materials of the All-Russian Jubilee Scientific Conference dedicated to the 100th anniversary of the birth of the Hero of the Soviet Union, Major General of the Medical Service Professor E.A. Dyskin, Saint Petersburg, January 14, 2023. Saint Petersburg: Military Medical Academy; 2023;140–143. (In Russ.).
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  8. Nucci R, de Souza R, Suemoto S, et al. Muscular structure of the diaphragm in the elderly: results of an autopsy study. Acta Histochem. 2020;122(2):122–124. doi: 10.1016/j.acthis.2019.151487
  9. Plessi M, Ramai D, Shah S. Clinical anatomy of the musculoskeletal part of the diaphragm. Surgical Radiology. 2015;37(9):1013–1033. doi: 10.1007/s00276-015-1481-0
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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Scheme of the measurement of the morphometric parameters of the abdominal surface of the diaphragm. Diameters of the orifices of the diaphragm: 1 — opening of the IV; 2 — aortic opening; 3 and 4 — length and width of the esophageal opening — respectively. Parameters of lumbar rib triangles: 5 and 6 — length and base of the right; 7 and 8 — length and base of the left. Morphometric characteristics of the diaphragm legs (length and transverse size): 9 and 10 — right medial leg; 11 and 12 — left; 13 and 14 — right intermediate leg; 15 and 16 — left; 17 and 18 — right lateral leg; 19 and 20 — left lateral leg. The area nuda is marked with a dotted line

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3. Fig. 2. The form of the area nuda after liver explantation is highlighted with a white punch

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