Current Developments in Thoracoscopic Sympathectomy

Ahn, Samuel S.; Wieslander, Cecilia K.; Ro, Kyung M.

doi:10.1007/s100169910070

Cited by 16 publications

(13 citation statements)

References 31 publications

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“…Minimally invasive ETS has evolved to become a safe, effective, and reproducible treatment for facial blushing and hyperhidrosis (HH) of the hands, axilla, or face. Large published series have shown success rates of 71-100% following ETS with improved quality of life and treatment satisfaction of 93-95% [3,4]. However, no randomized trials have yet been performed to demonstrate the superiority of ETS over non-surgical treatments.…”

Section: Introductionmentioning

confidence: 98%

Upper dorsal endoscopic thoracic sympathectomy: a comparison of one- and two-port ablation techniques

Murphy

Ghosh

Khwaja

et al. 2006

European Journal of Cardio-Thoracic Surgery

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Section: Introductionmentioning

confidence: 98%

Upper dorsal endoscopic thoracic sympathectomy: a comparison of one- and two-port ablation techniques

Murphy

Ghosh

Khwaja

et al. 2006

European Journal of Cardio-Thoracic Surgery

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“…Large series have shown success rates of 71-100% following conventional ETS for all forms of PHH with improved quality of life and treatment satisfaction of 93-95% [8,9]. Recent experience is obtained with even less-invasive surgery and single-port access techniques.…”

Section: Introductionmentioning

confidence: 99%

Single-port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach

Kuijpers

Klinkenberg

Bouma

et al. 2013

J Cardiothorac Surg

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BackgroundPrimary palmar and/or axillary focal hyperhidrosis is a frequent disorder characterized by excessive sweating beyond physiological needs, often leading to a substantial impairment of quality of life. Over the years several minimally invasive surgical treatments have been described, however results vary, and due to a lack of uniform surgical approach, technique and nomenclature are often difficult to compare. In this prospective study we sought to evaluate the safety and effectiveness of our standardized technique of single-port, one-stage bilateral thoracoscopic sympathicotomy.MethodsOn a prospective basis a hundred consecutive patients with severe or intolerable primary hyperhidrosis underwent one-stage bilateral single-port thoracoscopic sympathicotomy. Primary outcome was measured in pre- vs. post-operative Hyperhidrosis Disease Severity Scale scores. Location and extend of compensatory hyperhidrosis, and satisfaction with the procedure were registered.ResultsA significant reduction in mean Hyperhidrosis Disease Severity Scale score (3.69 ± 0.47 preoperatively vs. 1.06 ± 0.34 postoperatively) (p < 0.001) was observed. In 97 (97%) out of the 100 enrolled patients a >80% reduction in sweat production was achieved. Compensatory hyperhidrosis was seen in 27 patients (27%). It was rated as mild by 21 patients (78%) and as moderate by 6 (22%) of these patients. No severe compensatory hyperhidrosis was reported. Major complications, such as intraoperative bleeding, infections, and Horner’s syndrome were not observed.ConclusionsHighly selective sympathicotomy at well-defined levels with a one-stage bilateral single-port transaxillary thoracoscopic approach is a save procedure, with excellent and reproducible immediate results in the treatment of primary palmar and/or axillary hyperhidrosis.

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“…Though most case series reported immediate improvement in symptoms and healing of digital ulceration after ETS treatment for Raynaud's phenomenon, there remains controversy regarding the long-term efficacy of the procedure. 2 A recent longitudinal follow-up study of patients undergoing thoracoscopic sympathectomy found that one third of patients had a long-lasting benefit by 40 months of follow-up. 3 Recurrence of symptoms after ETS treatment for Raynaud's phenomenon is likely to be multi-factorial and may not reflect failure of the procedure.…”

Section: Discussionmentioning

confidence: 98%

Severe Raynaud's phenomenon—A streamlined approach to acute management

Lee

Lomas

Handa

2011

International Journal of Surgery Case Reports

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Raynaud's phenomenon is an exaggerated vasospastic response to cold or emotional stress which not only may cause the patient severe pain but also critical ischaemia and necrosis of the digits. We report the case of a 69-year-old woman who presented with rest pain, impending ulceration and necrosis of finger tips due to an episode of left-sided Raynaud's phenomenon. Intravenous prostacyclin was administered successfully as a bridge to endoscopic thoracic sympathectomy. Vascular surgery units are ideally positioned for the acute management of severe Raynaud's phenomenon to provide continuity of care to patients with profound digital ischaemia and impending tissue loss.

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Current Developments in Thoracoscopic Sympathectomy

Cited by 16 publications

References 31 publications

Upper dorsal endoscopic thoracic sympathectomy: a comparison of one- and two-port ablation techniques

Upper dorsal endoscopic thoracic sympathectomy: a comparison of one- and two-port ablation techniques

Single-port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach

Severe Raynaud's phenomenon—A streamlined approach to acute management

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