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Anatomical relationship between the terminal thoracic duct and brachial plexus: A cadaveric study
Adilson J M de Oliveira1,2,3, Mario Gilberto Siqueira1, João Paulo Mota Telles4
1Peripheral Nerves Group, Neurosurgery Discipline, Neurology Department, Hospital da Clinicas da Faculdade de Medicina da USP, São Paulo, Brazil.
Objective:
To study the anatomical relationship between the terminal portion of the thoracic duct (TD) and the brachial plexus (BP).
Methods:
Anatomical study performed on 72 fresh cadavers, dissected only on the left side. Anatomical structures were preserved, and measurements were performed using an digital caliper. Statistical analysis was performed with a 95% confidence interval and a precision level set at 3 mm.
Results:
The TD terminated on the left side in 100% of specimens. Three termination sites of the thoracic duct (TD) were identified: the internal jugular vein (50.0%), the junction between the internal jugular and subclavian veins (45.8%), and directly into the subclavian vein (4.2%). The TD ran parallel to the brachial plexus (BP) in 62.5% of cases and perpendicular in 37.5%. The structures closest to the TD were the phrenic nerve and the C5 root, at an average distance of 17 mm.
Discussion:
This anatomical proximity has important surgical implications. Understanding these relationships may reduce the risk of TD injury during BP surgeries.
Conclusion:
There is a consistent anatomical relationship between the TD and BP, typically within 2 cm, highlighting the need for careful dissection in this region.
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