Azygos lobe: a difficulty in video-assisted thoracic sympathectomy.
The presence of an azygos lobe (AL) may make it difficult or even impossible to use video-assisted thoracic sympathectomy if the surgeon is unprepared to deal with this anatomical anomaly. Seven hyperhidrosis patients with an AL from a total of 1,876 individuals who underwent video-assisted thoracic sympathectomy are presented. The surgical technique and clinical evolution are described. For these 7 patients, the surgical intervention could be performed using thoracoscopy. Only 1 patient required postoperative pleural drainage. Another patient presented atelectasis in part of the AL, which was resolved through respiratory physiotherapy. For all of them, the operation was completely successful. We concluded that it is possible to successfully perform VATS in the presence of an AL. Previous knowledge of the presence of AL is useful, so that surgeons are not taken by surprise during the operation.
Kauffman
Paulo
P
Department of Vascular Surgery, Hospital das Clínicas, Heart Institute (Incor), University of São Paulo Medical School, São Paulo, Brazil. paulo.kauffman@terra.com.br
Wolosker
Nelson
N
de Campos
José Ribas Milanez
JR
Yazbek
Guilherme
G
Jatene
Fábio Biscegli
FB
D000293:Adolescent; D000328:Adult; D000075202:Contraindications; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008168:Lung / Q000002:abnormalities*; D008297:Male; D013562:Sympathectomy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted; D055815:Young Adult