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An anatomical study of the relationship between the sympathetic trunk and intercostal veins of the third and fourth intercostal spaces during thoracoscopy.

 Seokjin Haam  ;  Dohyung Kim  ;  Jungju Hwang  ;  Hyochae Paik  ;  Dooyun Lee 
 CLINICAL ANATOMY, Vol.23(6) : 702-706, 2010 
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Adolescent ; Adult ; Blood Loss, Surgical/prevention & control ; Female ; Ganglia, Sympathetic/anatomy & histology* ; Humans ; Intercostal Nerves/anatomy & histology* ; Male ; Middle Aged ; Postoperative Hemorrhage/prevention & control ; Thoracoscopy ; Thorax/blood supply* ; Thorax/innervation* ; Veins/anatomy & histology* ; Young Adult
sympathetic nerve ; intercostal vein ; sympathetic surgery
The complexity of the anatomy of the sympathetic trunk and intercostal veins in the third and fourth intercostal space may lead to intraoperative or postoperative bleeding. The purpose of this study was to investigate the anatomical variations of the sympathetic trunk and intercostal veins in the third and fourth intercostal spaces. The size and crossing type of veins in the third and fourth intercostal spaces in 44 Korean patients with palmar hyperhidrosis were analyzed. We classified intercostal veins by their size (small, medium, and large) and crossing type (anterior or posterior to sympathetic nerve). Large intercostal veins susceptible to bleeding were found in 36.4 and 68.2% of patients in the right third and fourth intercostal spaces, respectively and in 2.3 and 4.5% of left third and fourth intercostal spaces, respectively. More than 80% of the left third and fourth intercostal veins were small. Anterior crossing intercostal veins, which often cause problems at the third and fourth right intercostal spaces, were found in 27.3% (third) and 15.9% (fourth). However, there were only two cases of anterior crossing veins on the left side. Large anterior crossing veins were found only on the right side. In conclusion, surgical procedures of the right sympathetic ganglia may have increased risks due to a higher frequency of large anterior crossing intercostal veins. Careful dissection is necessary to decrease the incidence of intraoperative or postoperative bleeding
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Paik, Hyo Chae(백효채) ORCID logo https://orcid.org/0000-0001-9309-8235
Lee, Doo Yun(이두연)
Haam, Seok Jin(함석진)
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