The authors summarize their therapeutic methods of palmar and axillary hyperhidrosis in this article. They discuss the characteristics, frequency of upper limb and patho-anatomical features of chronic sweating. Authors summarized their almost 40 years experience in treatment methods, technological improvements as well as they review recent knowledge and relevant literature. The open thoracotomic desympathization applied in the beginnings was gradually replaced by a minimally invasive VATS-sympathectomy (Video Assisted Thoracoscopic Surgery). The possibilities of conservative treatments, local excision methods will also be discussed, as well as the application and efficiency of Botox-treatments that are used in plastic surgery. The mean frequency of 0.1-1.0% described in scientific literature is indicative of a significant number of unresolved cases, which thus requires more efficient diagnostic and patient orientation practices. Based on their experiences, the most efficient treatment of upper limb hyperhidrosis is the thoracic sympathectomy (ramicotomy and the relevant T(2) -T(3) ganglia) according to Smithwick-procedure and modified by others. If necessary, one-stage bilateral VATS-surgery may be applied. Another effective conservative possibility is the Botox-therapy, which they had applied individually at the plastic surgery clinic. Significant complications or compensatory hyperhidrosis were not detected.
Esophageal strictures are well-known to the pediatric gastroenterology and surgery communities. Such strictures can arise from congenital malformations, inflammatory disorders, gastro-esophageal reflux disease (GERD), or even caustic substance ingestion. Rarely, in the instances of caustic ingestion, GERD, or inflammatory disorders, total obliteration of the esophageal lumen has been described. In those instances, as well as in those with high-grade stenosis refractory to dilations, esophageal reconstruction is the procedure of choice. However, in a small subset of adults with short-segment total esophageal obliteration after radiotherapy, an endoscopic rendezvous procedure has been described. Here we present a case of a 2-year-old female with total esophageal luminal obliteration with successful recanalization using an endoscopic rendezvous procedure. This case presents a unique approach to esophageal recanalization using a minimally invasive technique, only documented in the adult literature.
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