Lee Pei-Hsin, Hsieh Lin-Fen, Hong Chang-Zern
Department of Physical Medicine and Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Arch Phys Med Rehabil. 2003 Sep;84(9):1395-8. doi: 10.1016/s0003-9993(03)00135-7.
Unilateral brachial plexus injury is a rare complication of thoracoscopic sympathectomy, which is generally considered to be a simple and safe procedure. We report on a 26-year-old man who developed weakness and numbness of the right arm after thoracoscopic sympathectomy for hyperhidrosis. Electromyographic study revealed evidence of denervation in the upper trunk of the right brachial plexus. A nerve conduction study on the right axillary nerve revealed a reduced compound muscle action potential amplitude at the right deltoid muscle. We suggest that this complication was caused by stretch and/or compression when the arm was hyperabducted during the operation. The outcome was excellent, with almost complete recovery 3 months later. The complication can be prevented by minimizing operation time and avoiding hyperabduction of the arm. The prognosis for postoperative brachial plexopathy is usually good with conservative management.
单侧臂丛神经损伤是胸腔镜交感神经切除术的一种罕见并发症，而胸腔镜交感神经切除术通常被认为是一种简单且安全的手术。我们报告了一名26岁男性，他在因多汗症接受胸腔镜交感神经切除术后出现右臂无力和麻木。肌电图研究显示右侧臂丛神经上干有失神经支配的证据。对右侧腋神经的神经传导研究显示，右侧三角肌处复合肌肉动作电位幅度降低。我们认为，这种并发症是由手术过程中手臂过度外展时的拉伸和/或压迫所致。结果良好，3个月后几乎完全恢复。通过尽量缩短手术时间并避免手臂过度外展可预防该并发症。术后臂丛神经病变采用保守治疗，预后通常良好。
