Navegando por Palavras-chave "Variação Anatômica"

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    Estudo Anatômico Do Segundo, Terceiro E Quarto Gânglios Simpáticos Torácicos Utilizando Imagens Vídeo-Toracoscópicas E Sua Implicação Na Simpatectomia Torácica Para Tratamento Cirúrgico Da Hiperidrose Primária
    (Universidade Federal de São Paulo (UNIFESP), 2017-09-28) Leao, Eduardo Iwanaga [UNIFESP]; Leao, Luiz Eduardo Villaca [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Leão EI. Anatomical study of the second, third and fourth thoracic sympathetic ganglia using video-thoracoscopic images and their implication in thoracic sympathectomy for surgical treatment of primary hyperhidrosis. [Thesis] São Paulo: Escola Paulista de Medicina, Federal University of São Paulo; 2017 Introduction: Currently, thoracic thoracoscopy sympathectomy has been widely used in the surgical treatment of focal hyperhidrosis. The outcome of the proposed procedure, however, is directly related to the level where the sympathetic chain is disrupted. Usually the surgeon uses only the ribs as reference points, not considering the anatomical variations that these ganglia could present and thus interfering with the surgical result. Objectives: Through video-thoracoscopic recordings of bilateral thoracic sympathectomies in patients with localized primary hyperhidrosis: analyze and determine the anatomical variations of the second, third and fourth thoracic sympathetic ganglia and their relationship with the corresponding ribs. Method: We evaluated 70 video recordings of routine operations in patients with localized hyperhidrosis obtained at random. The 2nd, 3rd and 4th thoracic sympathetic ganglia (T2, T3 and T4) were directly identified and their anatomical relationships established with the corresponding ribs. The relationships between the sympathetic ganglia and the ribs were classified according to their location in the intercostal space (type A); On top of the lower rib (type B); At the body of the lower rib (type C) and located below the lower rib (type D). Results: On both, right and left sides, the location of T2 in 69 cases (98.5%) was in the second intercostal space, with only one case (1.5%), where the location occurred at the top of the third rib. On the right side, T3 had 49 cases (70%) in the third intercostal space, 18 cases (25.7%) on the top of the fourth rib and 3 cases (4.3%) on the fourth rib body. On the other hand, on the left side, prevalence also occurred as type A with 48 cases (68.5%), 20 cases (28.5%) as type B, 1 case (1.5%) type C and 1 case (1.5%) type D. Finally, the location of T4 on the right side presented 15 cases (21.4%) in the fourth intercostal space, 37 cases (52.8%) on the top of the fifth rib, 14 cases (20%) in the fifth rib body and 4 cases (5.8%) below this rib in the fifth intercostal space. On the left, 16 cases (22.8%) were type A, 39 cases (55.7%) type B, 14 cases (20%) type C and 1 case (1.5%) type D. Regarding the symmetry between the sides operated, we can say that there were 28 symmetrical (40%) and 42 asymmetric (60%) cases. Conclusion: Through the evaluation of the recorded videos obtained in routine operations, it was possible to identify the sympathetic ganglia T2, T3 and T4, as well as some of their anatomical variations and their relations with the ribs during thoracic sympathectomies for the treatment of primary hyperhidrosis.