Azygos lobe: a difficulty in video-assisted thoracic sympathectomy

Area of Science:

• Thoracic Surgery
• Anatomy
• Medical Imaging

Background:

• An azygos lobe (AL) can complicate video-assisted thoracic sympathectomy (VATS).
• Hyperhidrosis is a condition treatable by thoracic sympathectomy.
• Surgeons may be unprepared for AL during VATS.

Purpose of the Study:

• To evaluate the feasibility and outcomes of VATS in hyperhidrosis patients with an azygos lobe.
• To describe surgical techniques and clinical evolution in these specific cases.

Main Methods:

• Retrospective review of 7 hyperhidrosis patients with an AL undergoing VATS.
• Description of surgical technique and postoperative management.
• Analysis of clinical outcomes and complications.

Main Results:

• VATS was successfully performed in all 7 patients with an AL.
• One patient required pleural drainage; another experienced partial atelectasis resolved with physiotherapy.
• All patients achieved complete success with the operation.

Conclusions:

• Video-assisted thoracic sympathectomy is a viable surgical option for hyperhidrosis even in the presence of an azygos lobe.
• Preoperative identification of an azygos lobe is beneficial for surgical planning and preparedness.
• Surgeons should be aware of this anatomical anomaly to ensure successful outcomes.