title: Azygos lobe: a difficulty in video-assisted thoracic sympathectomy.
abstract: 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.
authors.affiliation: Department of Vascular Surgery, Hospital das Clínicas, Heart Institute (Incor), University of São Paulo Medical School, São Paulo, Brazil. paulo.kauffman@terra.com.br
authors.forename: Paulo
authors.initials: P
authors.lastname: Kauffman
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
authors.forename: José Ribas Milanez
authors.initials: JR
authors.lastname: de Campos
authors.forename: Guilherme
authors.initials: G
authors.lastname: Yazbek
authors.forename: Fábio Biscegli
authors.initials: FB
authors.lastname: Jatene
mesh_terms: 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