Video-assisted Transthoracic Sympathectomy in the Treatment of Primary Hyperhidrosis: Friend or Foe?

Fredman, Brian; Zohar, Edna; Shachor, Dov; Bendahan, Jose; Jedeikin, Robert

doi:10.1097/00129689-200008000-00009

Cited by 42 publications

(23 citation statements)

References 16 publications

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“…In previous studies, postoperative pain was reported between 0.8 and 93 % for thoracoscopic surgeries [2,10,11,13,[17][18][19]. Pain at the time of discharge affected 20 % of the patients, which decreased to 10 % at the tenth day of postoperation in our study.…”

Section: Discussionsupporting

confidence: 53%

Sympathectomy for Palmar Hyperhidrosis

Tülay

2013

Indian J Surg

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Palmar hyperhidrosis is an important situation that may cause emotional and work-related problems. Although local treatment and psychotherapy have been used for palmar hyperhidrosis, the choice of treatment for palmar hyperhidrosis is video-assisted thoracoscopic sympathectomy. Retrospective analysis of 120 bilateral thoracoscopic sympathectomies (60 patients) was done in this study. Earlier, 12 of 60 patients (20 %) had been operated on by other surgeons who used clipping method for palmar hyperhidrosis in different hospitals within 1 year. The procedure was performed under general anesthesia using single-lumen endotracheal tube. Sympathetic chain resection was performed between lower level of the second rib and upper level of the fourth rib. Intercostal blockage at three levels was performed, while thoracoscopic control of the injection sites was done. We observed improvement of symptoms in 95 %, mild compensatory sweating in 20 %, and excessive dryness of hands in 10 % in our patients.

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Section: Discussionsupporting

confidence: 53%

Sympathectomy for Palmar Hyperhidrosis

Tülay

2013

Indian J Surg

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“…Its rate in some series ranged between 60 and 90% [14][15][16][17][18][19][20]. It typically appears after 6 to 12 months, with females being more susceptible and is not related to the extension of the TS [13].…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic excision of the sympathetic chain: an easy and effective treatment for hyperhidrosis in children

et al. 2011

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“…Indeed, despite having dry hands as a result of surgery, patients may report only moderate satisfaction, dissatisfaction or even regret having undergone the operation because of the appearance of CS [10][11][12]. The specific rate of CS in some recent series ranged between 60 and 90%, and it was considered as being severe in one-third of them [13][14][15][16]. Our rate of CS was 81.8%, with a significant difference between children (69.8%) and adults (88.5%).…”

Section: Discussionmentioning

confidence: 99%

Do children tolerate thoracoscopic sympathectomy better than adults?

et al. 2007

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Palmar hyperhidrosis (PHH) is fairly a common condition, which is treatable by thoracoscopic sympathectomy (TS). Compensatory sweating (CS) is a major side effect of TS. We compared the TS procedure's long-term success, patient's satisfaction and complications between children (< or =14 years of age) and adolescents and adults (> or =15 years of age). A chart review of the patients who had undergone TS at three medical centers (Hillel Yaffe, Soroka and Bnai-Zion) who could be contacted and agreed to reply to a detailed telephone questionnaire yielded 325 patients with a >24-month follow-up. There were 116 children and 209 adolescents and adults with a follow-up of 2-8 years. Most participants (96.3%) reported complete or reasonable symptomatic relief. The long-term postoperative satisfaction was high (84.5%), and significantly higher among children (92.2%) compared to adolescents and adults (80.7%) (P = 0.005). CS appeared within 6 months postoperatively in 81.8% of all the patients but significantly less in children (69.8%) compared to the others (88.5%; P < 0.001). CS increased with time in 12% of the participants, but decreased in 20.8% of the children versus 10.5% of the others (P = 0.034), usually within the first two postoperative years. The severity of the CS was also lower in children: it was absent or mild in 54.3% of the children versus 38.0% of the others, and moderate or severe in 45.7 versus 62%, respectively (P = 0.004). Fifty-one percent of the participants claimed that their quality of life decreased moderately or severely as a result of CS, but only one-third of them (7.9% children vs. 22.4% others, P = 0.001) would not have undergone the operation in retrospect. Thoracoscopic sympathectomy relieves PHH in most cases. Most patients prefer relief from PHH even at the cost of moderate or severe CS. The rate of CS and its severity is tolerated better by children, and their postoperative satisfaction is higher than that of adolescents and adults. Therefore, unless otherwise contraindicated, we recommend doing TS as early as possibly.

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Video-assisted Transthoracic Sympathectomy in the Treatment of Primary Hyperhidrosis: Friend or Foe?

Cited by 42 publications

References 16 publications

Sympathectomy for Palmar Hyperhidrosis

Sympathectomy for Palmar Hyperhidrosis

Thoracoscopic excision of the sympathetic chain: an easy and effective treatment for hyperhidrosis in children

Do children tolerate thoracoscopic sympathectomy better than adults?

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