Under general anesthesia with single-lumen endotracheal tube, all patients were positioned in the semi-sitting supine position at 45° with both arms abducted to 90°. Trocar (5 mm) was placed in the 4th intercostal space on the bilateral anterior axillary line, a 5-mm camera was introduced and Trocar was removed. A microelectrocautery hook was inserted along the original incision upon the camera, and artificial pneumothorax and the respiratory suspension were used to keep pulmonary collapse. In group A, we sectioned the R3 rami communicantes by fulgurating 2-cm outward along the lateral edge of the sympathetic chain in 2–3 mm of the third rib, leaving R3 sympathetic chain untouched, then fulgurating R4 sympathetic chain and R4 rami communicantes along the fourth rib (Figure 1 ). In group B, R3 sympathetic chain and R3 rami communicantes were severed by fulgurating along the third rib. The incision was closed after lung aeration recruitment, and thoracic imaging tests were reexamined after surgery to ensure there was no evidence of a pneumothorax or hemothorax before patients were discharged from the hospital.
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