BACKGROUND: Hyperhidrosis palmaris is a functionally and socially disabling problem. Thoracic sympathectomy of the T2 ganglion has proved to be the time-honored treatment modality. STUDY DESIGN: The results of this study demonstrate the effectiveness of video-assisted thoracoscope for treatment of hyperhidrosis palmaris. The possibility to apply different anesthetic techniques and to measure surface temperature change of the hand were documented as well. RESULTS: Eighty consecutive cases (159 procedures) of essential hyperhidrosis palmaris were treated by video-assisted thoracoscopic T2 sympathectomy between January 1991 and December 1992. The surgical results were classified as excellent (much improved, very dry) in 88.1 percent, good (improved, minimal wet) in 9.4 percent, and fair (slightly improved, still wet) in 2.5 percent of the patients. The postoperative complications included one prolonged air leakage, one hemothorax, two wound infections, and 15 cases of facial anhidrosis. There were no recurrent cases (mean follow-up, 14.5 months). Fifty-six patients had concomitant hyperhidrosis pedum. Interestingly enough, through unknown mechanism, 64.3 percent of the patients with concomitant hyperhidrosis pedum were cured after this procedure. CONCLUSIONS: Video-assisted thoracoscopy provides magnified surgical fields, which make thoracoscopic sympathectomy for hyperhidrosis palmaris an effective, safe, easy to use, and time-saving procedure. This technique is also excellent for teaching purposes and allows the assistant to participate in the operation.
BACKGROUND:Hyperhidrosis palmaris is a functionally and socially disabling problem. Thoracic sympathectomy of the T2 ganglion has proved to be the time-honored treatment modality. STUDY DESIGN: The results of this study demonstrate the effectiveness of video-assisted thoracoscope for treatment of hyperhidrosis palmaris. The possibility to apply different anesthetic techniques and to measure surface temperature change of the hand were documented as well. RESULTS: Eighty consecutive cases (159 procedures) of essential hyperhidrosis palmaris were treated by video-assisted thoracoscopic T2 sympathectomy between January 1991 and December 1992. The surgical results were classified as excellent (much improved, very dry) in 88.1 percent, good (improved, minimal wet) in 9.4 percent, and fair (slightly improved, still wet) in 2.5 percent of the patients. The postoperative complications included one prolonged air leakage, one hemothorax, two wound infections, and 15 cases of facial anhidrosis. There were no recurrent cases (mean follow-up, 14.5 months). Fifty-six patients had concomitant hyperhidrosis pedum. Interestingly enough, through unknown mechanism, 64.3 percent of the patients with concomitant hyperhidrosis pedum were cured after this procedure. CONCLUSIONS: Video-assisted thoracoscopy provides magnified surgical fields, which make thoracoscopic sympathectomy for hyperhidrosis palmaris an effective, safe, easy to use, and time-saving procedure. This technique is also excellent for teaching purposes and allows the assistant to participate in the operation.
Authors: Nelson Wolosker; Guilherme Yazbek; José Ribas Milanez de Campos; Paulo Kauffman; Augusto Ishy; Pedro Puech-Leão Journal: Clin Auton Res Date: 2007-06-12 Impact factor: 4.435
Authors: Nelson Wolosker; Augusto Ishy; Guilherme Yazbek; Jose Ribas Milanez de Campos; Paulo Kauffman; Pedro Puech-Leão; Fabio Biscegli Jatene Journal: Clinics (Sao Paulo) Date: 2013 Impact factor: 2.365