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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.
Brain & Spine
|June 15, 2026
Summary
The thoracic duct (TD) consistently relates anatomically to the brachial plexus (BP), typically within 2 cm. This proximity is crucial for surgeons to avoid TD injury during BP procedures.
Area of Science:
- Anatomy
- Surgical Anatomy
Background:
- The thoracic duct (TD) is the largest lymphatic vessel in the body.
- The brachial plexus (BP) is a network of nerves crucial for upper limb function.
Purpose of the Study:
- To investigate the anatomical relationship between the terminal portion of the thoracic duct (TD) and the brachial plexus (BP).
Main Methods:
- Anatomical dissection of 72 fresh cadavers (left side only).
- Precise measurements of anatomical structures using a digital caliper.
- Statistical analysis with a 95% confidence interval and 3 mm precision.
Main Results:
- The TD terminated on the left side in 100% of specimens.
- Common TD termination sites include the internal jugular vein (50.0%) and the junction of the internal jugular and subclavian veins (45.8%).
- The TD ran parallel to the BP in 62.5% of cases, with the phrenic nerve and C5 root being the closest structures (average 17 mm).
Conclusions:
- A consistent anatomical relationship exists between the TD and BP, typically within 2 cm.
- Understanding this proximity is vital for reducing TD injury risk during brachial plexus surgeries.
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