BackgroundVideo-assisted thoracoscopic sympathicotomy has been determined to be the best way to treat palmar hyperhidrosis. However, satisfaction with the surgical outcomes decreases with the onset of compensatory hyperhidrosis (CH) over time. The ideal level of sympathicotomy is controversial. Therefore, we compared the long-term results of R3 and R4 sympathicotomy.MethodsWe retrospectively reviewed 186 patients who underwent video-assisted thoracoscopic sympathicotomy between September 2001 and September 2015. We analyzed the long-term results with respect to hand sweating and CH, and the overall satisfaction in 186 patients.ResultsWith respect to hand sweating, significantly more patients complained of overly dry hands in the R3 group (25% versus 3.7%, p<0.001) and of mildly wet hands in the R4 group (2.9% versus 13.4%, p=0.007). There was a significantly increased occurrence rate of CH in the R3 group (97.1% versus 65.9%, p< 0.001). The most frequent site of CH was the trunk area. The overall satisfaction was higher in the R4 group, but without significance (75% versus 85.4%, p=0.082). Significantly more patients reported being very satisfied in the R4 group (5.8% versus 22.0%, p=0.001).ConclusionThe R4 group had a higher rate of satisfaction than the R3 group with respect to hand sweating. CH and hand dryness were significantly less common in the R4 group than in the R3 group. The lower occurrence of hand dryness and CH resulted in a higher satisfaction rate in the R4 group.

Adequate maintenance of body temperature during general anesthesia is necessary for patients' safety. Perioperative thermal disturbance can cause numerous adverse outcomes such as wound infection, coagulopathy, delayed postanesthetic recovery, and prolonged hospitalization [1][2][3]. Core temperature can be accurately monitored at the tympanic membrane, distal esophagus, nasopharynx, and pulmonary artery [4]. Generally, esophageal temperature probe is used because of its reliability [5] and feasibility in practice. Liu et al. [6] suggested that esophageal temperature is more reliable than tympanic temperature during thoracotomy. Proper placement of esophageal temperature probe is important to avoid unwanted complications: inadvertent temperature reading, airway irritation, and serious hypoxemia [7][8][9].Herein, we reported a rare complication involving esophageal temperature probe which was misplaced into the right intermediate bronchus and accidentally cut in a patient undergoing lobectomy of the lung. CASE REPORTA 79-year-old man (height 163 cm, body weight 63 kg) was scheduled to undergo middle and lower bilobectomy of the right lung through video-assisted thoracic surgery. The patient was diagnosed with adenocarcinoma of the right middle lobe. Chest radiographic examination before surgery revealed a 3-cm sized mass-like lesion at the right middle lobe bronchus with distal segmental atelectasis; pulmonary function test showed normal results; and systemic positron emission computed tomography showed no metastasis except in the right lung.On entrance into the operation room, patients' intraarterial blood pressure, electrocardiography, pulse oximetry, end-tidal CO 2 , and central venous pressure were monitored.Temperature of the operation room was set at 25°C and breathing circuit was automatically heated and humidified.After induction with propofol and remifentanil through target-controlled infusion, the trachea was intubated with 37 Fr

A 36-year-old man visited Yeungnam University Hospital with a sudden onset of palpitation, headache, and was found to be hypertensive. Chest radiography showed a 6 cm sized mass lesion on the posterior mediastinum. A biochemical study showed elevated levels of catecholamines. An I-123 metaiodobenzylguanidine scan revealed a hot uptake lesion on the posterior mediastinum. The patient was prepared for surgery with α and β blocking agents. Two months later, we removed the tumor successfully. A histological study proved that the resected tumor was mediastinal pheochromocytoma. Functional mediastinal pheochromocytomas are rare. Therefore, we reported the case with a literature review.

Background Predicting postoperative lung function after pneumonectomy is essential. We retrospectively compared postoperative lung function to predicted postoperative lung function based on computed tomography (CT) volumetry and perfusion scintigraphy in patients who underwent pneumonectomy. Methods Predicted postoperative lung function was calculated based on perfusion scintigraphy and CT volumetry. The predicted function was compared to the postoperative lung function in terms of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV 1 ), using 4 parameters FVC, FVC%, FEV 1 , and FEV 1 %. Results The correlations between postoperative function and predicted function based on CT volumetry were r=0.632 (p=0.003) for FVC% and r=0.728 (p<0.001) for FEV 1 %. The correlations between postoperative function and predicted postoperative function based on perfusion scintigraphy were r=0.654 (p=0.002) for FVC% and r=0.758 (p<0.001) for FEV 1 %. The preoperative Eastern Cooperative Oncology Group (ECOG) scores were significantly higher in the group in which the gap between postoperative FEV 1 and predicted postoperative FEV 1 analyzed by CT was smaller than the gap analyzed by perfusion scintigraphy (1.2±0.62 vs. 0.4±0.52, p=0.006). Conclusion This study affirms that CT volumetry can replace perfusion scintigraphy for preoperative evaluation of patients needing pneumonectomy. In particular, it was found to be a better predictor of postoperative lung function for poor-performance patients (i.e., those with high ECOG scores).

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