<i>In vivo</i>study of the surgical anatomy of the axilla

Khan, Ayesha; Chakravorty, Arunmoy; Gui, Gerald

doi:10.1002/bjs.8737

Cited by 37 publications

(22 citation statements)

References 22 publications

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“…The same cannot be said for the LTA, which was absent in 45% of the cases evaluated. Most commonly, drainage of the LTV into the axillary vein anteromedial to the TDP was observed, confirming the findings of Khan et al (2012). However, in all of the cases studied, there was no communication between the LTV and the subscapular vein before the axillary vein was reached.…”

Section: Discussionsupporting

confidence: 89%

“…They were chosen due to its potential of variability, identified and referred to as described in Gray’s anatomy atlas (Standring 2008) and in previously published articles that have addressed this subject (Loukas et al 2006; Khan et al 2012; Nadkarni & Raina 2006; Macéa & Fregnani 2006). To obtain a better understanding, ICBN was divided into three distinct anatomical structures: the first ICBN, identified from the second intercostal space, at the top of the axilla, originating in the second intercostal nerve (T2); the second ICBN, identified from the third intercostal space and originating in the third intercostal nerve (T3); and the third ICBN, identified from the fourth intercostal space in the caudal region of the axilla and originating from the fourth intercostal nerve (T4).…”

Section: Methodsmentioning

confidence: 99%

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Anatomical variations of the axilla

Soares

2014

SpringerPlus

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PurposeThe present study aimed to measure the thickness of the subcutaneous adipose tissue (SAT) at the site of the surgical incision for axillary lymph node dissection (ALND) and to record potential anatomical variations in the medial cutaneous nerve of the arm (MCNA), the intercostobrachial nerve (ICBN), the lateral thoracic vein (LTV), the lateral thoracic artery (LTA) and the pectoral muscle pedicle (PMP), considering that some details of the anatomy of these structures within the axilla are still unclear.MethodsA prospective study was conducted in 100 consecutive patients with breast cancer who underwent ALND as part of surgical treatment. The anatomy of the dissected axilla was video recorded.ResultsThe SAT thickness ranged from 8 mm to 60 mm, with an average thickness of 25.9 mm. A positive correlation was observed between the SAT thickness and the body mass index (BMI) of the evaluated patients (r = 0.68; p < 0.0001). The MCNA was the anatomical structure that was least commonly observed in the axilla (22% of cases), while the PMP was the most constant element, identified in 100% of cases. All of the studied anatomical structures observed within the axilla showed variation in at least one of the aspects analyzed, i.e., the point of entry and exit, path, number and location of divisions or branches.ConclusionThe present study demonstrated wide variation in thickness of the SAT overlying the axilla and identified the existence of broad normative anatomical variation of the axilla.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-306) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

Anatomical variations of the axilla

Soares

2014

SpringerPlus

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“…These landmarks are constantly well seen in all our cases during axillary dissection. However, there is an aberrant course of the TDN in some reported series, which is not detected in our series [3]. …”

Section: Clinical Anatomycontrasting

confidence: 70%

ecancermedicalscience

Zin

Maw²,

Oo³

et al.

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Breast cancer surgery frequently involves an axillary clearance procedure for nodal metastases. Injury to the thoracodorsal nerve is one of the complications related to the axillary dissection. The thoracodorsal nerve innervates the latissimus dorsi muscle which facilitates in certain movements of the arm. Moreover, it can be used as a nerve graft in long thoracic nerve injury whether in trauma or surgery. Understanding the anatomy structures and good surgical technique in the axillary clearance procedure can identify and prevent such an injury to the thoracodorsal nerve. Here, we demonstrate a simple and effortless technique for identification of the thoracodorsal nerve during axillary surgery.

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“…The ICBN was identified as a single trunk at its origin in 93.3% of the cases dissected. The description of this pattern ranged from 74% to 81.3% in other studies 8,10,14,28 . In this study, the average diameter of the ICBN at its origin in the second intercostal space was 2.1 ± 0.7 mm, similar to the result of 1.89 ± 0.44 mm described by Zhu et al 14 .…”

Section: Discussionmentioning

confidence: 73%

The intercostobrachial nerve as a sensory donor for hand reinnervation in brachial plexus reconstruction is a feasible technique and may be useful for restoring sensation

Foroni

Siqueira

Martins

et al. 2017

Arq. Neuro-Psiquiatr.

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ARTICLEThe intercostobrachial nerve as a sensory donor for hand reinnervation in brachial plexus reconstruction is a feasible technique and may be useful for restoring sensation O uso do nervo intercostobraquial como doador na restauração cirúrgica da sensibilidade da mão em lesões do plexo braquial é uma técnica anatomicamente viável e pode ser útil para a recuperação sensitiva ABSTRACTObjective: Few donors are available for restoration of sensibility in patients with complete brachial plexus injuries. The objective of our study was to evaluate the anatomical feasibility of using the intercostobrachial nerve (ICBN) as an axon donor to the lateral cord contribution to the median nerve (LCMN). Methods: Thirty cadavers were dissected. Data of the ICBN and the LCMN were collected, including diameters, branches and distances. Results: The diameters of the ICBN and the LCMN at their point of coaptation were 2.7mm and 3.7mm, respectively. The ICBN originated as a single trunk in 93.3% of the specimens and bifurcated in 73.3%. The distance between the ICBN origin and its point of coaptation to the LCMN was 54mm. All ICBNs had enough extension to reach the LCMN. Conclusion: Transfer of the ICBN to the LCMN is anatomically feasible and may be useful for restoring sensation in patients with complete brachial plexus injuries.Keywords: brachial plexus; intercostal nerves; median nerve; nerve transfer; sensation. RESUMOObjetivo: Poucos doadores estão disponíveis para a restauração da sensibilidade em pacientes com lesões completas do plexo braquial (LCPB). O objetivo deste estudo foi avaliar a viabilidade anatômica do uso do nervo intercostobraquial (NICB) como doador de axônios para a contribuição do cordão lateral para o nervo mediano (CLNM). Métodos: Trinta cadáveres foram dissecados. Os dados do NICB e do CLNM foram coletados: diâmetros, ramos e distâncias. Resultados: Os diâmetros do NICB e da CLNM no ponto de coaptação foram 2,7mm e 3,7mm, respectivamente. O NICB originou-se como um único tronco em 93,3% dos espécimes e bifurcou-se em 73,3%. A distância entre a origem do NICB e seu ponto de coaptação com a CLNM foi de 54mm. Todos os NICBs tiveram extensão suficiente para alcançar a CLNM. Conclusão: A transferência do NICB para a CLNM é anatomicamente viável e pode ser útil para restaurar a sensibilidade em pacientes com LCPB.Palavras-chave: plexo braquial; nervos intercostais; nervo mediano; transferência de nervo; sensação.

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In vivostudy of the surgical anatomy of the axilla

Cited by 37 publications

References 22 publications

Anatomical variations of the axilla

Anatomical variations of the axilla

ecancermedicalscience

The intercostobrachial nerve as a sensory donor for hand reinnervation in brachial plexus reconstruction is a feasible technique and may be useful for restoring sensation

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