A single incision transaxillary thoracoscopic sympathectomy
Background/Aim. Primary hyperhidrosis causes are unknown. The disorder begins in early childhood. It intensifies in puberty and maturity. It is equally present in both sexes. The symptoms exacerbate when the body temperature rises and due to emotional stimuli affecting the sympathetic nerve...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2014-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2014/0042-84501300047M.pdf |
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| Summary: | Background/Aim. Primary hyperhidrosis causes are unknown. The disorder begins
in early childhood. It intensifies in puberty and maturity. It is equally
present in both sexes. The symptoms exacerbate when the body temperature
rises and due to emotional stimuli affecting the sympathetic nerve system.
The aim of this study was to demonstrate that videoassisted thoracoscopic
surgery (VATS) sympathectomy is a method for primary focal hyperhidrosis
permanent treatment. The single incision method in properly selected patients
maximizes the intervention effectiveness and minimizes aesthetic side
effects. Methods. This prospective study analysed the findings in patients
who had been operated on due to primary focal hyperhidrosis (face, palms, and
armpits) using a single small transaxilarry incision in the third inter-rib
space at the level of the anterior axillary line with two 5 mm flexible
ports. All the patients, with T2-T5 thoracoscopic sympathectomy of the
sympathetic chain using a single small incision in the third inter-rib space
in the anterior axillary line, were analysed in the period from September
2009 to November 2010 regarding the postoperative morbidity and outcomes of
the operation (clinical evaluation and visual analogue scale) with a view to
assessing the effectiveness of the surgery conducted in this manner. Results.
A total of 47 patients (18 men, 29 women), 18 to 48 years old (29 on average)
had underwent 94 bilateral video-assisted thoracoscopic sympathectomies. The
sympathectomy was indicated in cases of facial blushing and sweating (6.38%),
palmary sweating (34.04%), axillary sweating (14.89%) or both palmary and
axillary sweating (44.68%). The largest percentage of patients (98.6%) had
left the hospital the following day. The postoperative 30 day’s mortality was
0 and the conversion into open surgery was not necessary. As for
complications, there had been an occurrence of partial pneumothorax in two
patients treated by means of exuflation and chest drain, and one case of
unilateral transitory Horner’s syndrome. Quarterly and annual postoperative
monitoring showed excellent aesthetic effects of the surgery without any
residual pain. The complete withdrawal of hyperhidrosis symptoms was noted in
44 (93.62%) of the patients. The recurrence of symptoms following the initial
regression was seen in 3 (6.38%) of the patients 12 months after the surgery,
whereas the patients surgically treated as a result of facial hyperhidrosis
saw a significantly increased sweating of feet. The quality of life improved
in 45 (95.6%) of the patients. Conclusion. Single incision transaxillary
thoracoscopic sympathectomy generates excellent aesthetic and functional
results in patients with primary focal hyperhidrosis. |
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| ISSN: | 0042-8450 |