Surgical anatomy of upper thoracic sympathetic nerve

石献忠 栾丽菊 刘彦国 陈春花 金铎 刘胜勇 周长满 张卫光

doi:10.16098/j.issn.0529-1356.2026.01.015

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Acta Anatomica Sinica ›› 2026, Vol. 57 ›› Issue (1) : 100-104. DOI: 10.16098/j.issn.0529-1356.2026.01.015

Anatomy

Surgical anatomy of upper thoracic sympathetic nerve

SHI Xian-zhong¹, LUAN Li-ju¹, LIU Yan-guo², CHEN Chun-hua¹, JIN Duo¹, LIU Sheng-yong¹, ZHOU Chang-man¹, ZHANG Wei-guang^1*

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Abstract

Objective To clearly delineate the microanatomy of the upper thoracic sympathetic trunk and its syntopy in order to provide anatomical basis for the selection of precise clinical surgical approaches. Methods Totally 55 sympathetic trunks available in 28 Chinese adult cadavers (18 males and 10 females) were investigated in this study. The thoracic cavity was thoroughly exposed and then sympathetic ganglia and its affiliated rami were observed and measured with microscopic instruments. Results Rami from thoracic nerve 1 (T1) intercostal nerve entered the stellate ganglion above the upper border of the second rib in all specimens. The distance between the rami and the upper border of the second rib was (5.1 ± 1.4) mm. The incidence that T2-T5 ganglions located at the corresponding intercostal space was 92.7%, 85.5%, 40.0% and 36.4%, respectively. The rami communicantes were classified into 3 types (type a, b and c) according to the anatomical relationship between the thoracic sympathetic ganglia and the intercostal nerves. The distance from 3 types of rami communicantes to lateral sympathetic trunk at the middle point of relative rib was (10.2 ± 3.4) mm (type a), (9.5 ± 2.6) mm (type b) and (8.4 ± 2.0) mm (type c), respectively. We found that 74.5% superior intercostal artery crossed the neck of the first rib. The distance between the superior intercostal artery and the lateral sympathetic trunk was (3.4 ± 1.3) mm. Conclusion Sympathectomy performed at rib level should be the ideal choice for clinical surgical treatment of palmar or craniofacial hyperhidrosis with less denervation scope to achieve more definite therapeutic effect.

Key words

Sympathetic trunk / Sympathectomy / Surgical anatomy

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SHI Xian-zhong, LUAN Li-ju, LIU Yan-guo, CHEN Chun-hua, JIN Duo, LIU Sheng-yong, ZHOU Chang-man, ZHANG Wei-guang. Surgical anatomy of upper thoracic sympathetic nerve[J]. Acta Anatomica Sinica. 2026, 57(1): 100-104 https://doi.org/10.16098/j.issn.0529-1356.2026.01.015

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