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Titolo:
Video-assisted thoracoscopic "resympathicotomy" for palmar hyperhidrosis: Analysis of 42 cases
Autore:
Lin, TS;
Indirizzi:
Changhua Christian Hosp, Chung Shan Med & Dent Coll, Div Gen Thorac Surg, Taichung, Taiwan Changhua Christian Hosp Taichung Taiwan n Thorac Surg, Taichung, Taiwan
Titolo Testata:
ANNALS OF THORACIC SURGERY
fascicolo: 3, volume: 72, anno: 2001,
pagine: 895 - 898
SICI:
0003-4975(200109)72:3<895:VT"FPH>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSTHORACIC ENDOSCOPIC SYMPATHECTOMY; THORACIC SYMPATHECTOMY; RESYMPATHECTOMY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Lin, TS 135,Nanh Siao St, Changhua, Taiwan 135,Nanh Siao St Changhua Taiwan Nanh Siao St, Changhua, Taiwan
Citazione:
T.S. Lin, "Video-assisted thoracoscopic "resympathicotomy" for palmar hyperhidrosis: Analysis of 42 cases", ANN THORAC, 72(3), 2001, pp. 895-898

Abstract

Background. There are rare reports of video-assisted thoracoscopic resympathicotomy for patients with palmar hyperhidrosis. I present our experience in treating a persistent or recurrent palmar hyperhidrosis after primary endoscopic sympathectomy or sympathicotomy and discuss the perioperative management. Methods. We reoperated on 42 patients using a technique of video-assisted thoracoscopic resympathicotomy. All patients were placed in a semi-sitting position under single- or double-lumen intubated anesthesia. An 8-mm, 0 degrees thoracoscope was used to interrupt the nerve conduction to the palms from the T2 and T3 ganglia, through one or two 0.8-cm subaxillary incisions. Results. The reasons for failure of endoscopic sympathectomy or sympathicotomy in 26 patients included pleural adhesion (15 of 26, 57.7%), incorrect identification of T2 ganglion (3 of 26, 11.5%), vessel overriding or close to sympathetic nerve (3 of 26, 11.5%), incomplete interruption of sympathetic nerve (2 of 26, 7.7%), medially located sympathetic nerve (2 of 26, 7.7%), and aberrant venous arch (1 of 26, 3.8%). The causes of recurrent palmarhyperhidrosis after primary transthoracic endoscopic sympathicotomy or sympathectomy (TES) in 16 patients included a possible effect of T3 ganglion (8 of 16, 50%), Kuntz fiber (3 of 16,18.8%), nerve regeneration (3 of 16, 18.8%), and incomplete interruption of T2 ganglion (2 of 16, 12.5%). Surgicalcomplications included pneumothorax (1 patient, 2.4%), hemothorax (1 patient, 2.4%), and compensatory sweating (36 patients, 86%). All patients had obtained successful bilateral sympathectomies and had satisfactory results after a mean of 32.1 months of follow-up. Conclusions. Video-assisted thoracoscopic resympathicotomy is an effectiveand safe method for a previously unsuccessful sympathectomy or recurrent palmar hyperhidrosis if the surgeon acknowledges possible anatomic variations and can overcome the problems related to pleural adhesions. (C) 2001 by The Society of Thoracic Surgeons.

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Documento generato il 20/01/21 alle ore 02:48:53