Simpatectomia torácica por videotoracoscopia

Montessi, Jorge; Almeida, Edmilton Pereira de; Vieira, J.; Abreu, Marcus da Matta; Souza, Renato Lucas Passos de; Montessi, Oswaldo Victor Duarte

doi:10.1590/s1806-37132007000500023

Cited by 5 publications

(11 citation statements)

References 4 publications

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“…(5,(7)(8)(9)(10)12) The reported incidence of post-operative compensatory sweating ranges from 30% to 84%. (12) There have been discrepancies among studies in terms of the results and complication rates reported, due in part to the lack of clear-cut criteria for selecting surgical candidates, failed procedures, complications and side effects, as well as to differences in the collection of short-and long-term follow-up data.…”

Section: Discussionmentioning

confidence: 99%

“…(7)(8)(9) To achieve a high level of patient satisfaction, it is useful to identify some predictive factors for compensatory sweating. (10) Identifying the profile of the ideal candidate for thoracoscopic sympathectomy is of utmost importance and facilitates the appropriate selection of patients. The aim of this study was to investigate predictive factors for compensatory sweating after thoracoscopic sympathectomy, as well as their influence on the frequency, location and severity of compensatory sweating.…”

Section: Introductionmentioning

confidence: 99%

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Compensatory sweating after thoracoscopic sympathectomy: characteristics, prevalence and influence on patient satisfaction

et al. 2009

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Objective: This prospective study aimed at investigating predictive factors for compensatory sweating after thoracoscopic sympathectomy. Methods: From 2000 to 2002, 80 patients (53 females and 27 males) underwent thoracoscopic sympathectomy to treat hyperhidrosis. Patient ages ranged from 12 to 56 years, and the mean postoperative follow-up period was 42.51 ± 5.98 months. Patient satisfaction with the results was evaluated through the use of a rating scale. The procedure was performed bilaterally: at the T2 level for facial hyperhidrosis; at the T3-T4 level for axillary hyperhidrosis; and at the T3 level for palmar hyperhidrosis. Results: Post-operatively, 68 patients (85.0%) presented compensatory sweating, which was classified as mild in 23 (33.8%), moderate in 23 (33.8%) and severe in 22 (32.4%). Considering the final surgical results, 70 patients (87.5%) were satisfied with the outcome of the operation, whereas 10 patients (12.5%) were dissatisfied. The level of patient satisfaction varied according to gender, age, body mass index (BMI) and extent of denervation. The compensatory sweating was more severe on the abdomen and back than on the legs. Conclusions: Although compensatory sweating, which is a common adverse effect of sympathectomy, occurred in the majority of cases, the level of patient satisfaction was high. The best candidates for thoracoscopic sympathectomy are young adult women with a BMI ≤ 24.9 kg/m 2 .Keywords: Sympathectomy; Hyperhidrosis; Thoracoscopy; Postoperative complications; Thoracic surgery, video-assisted. ResumoObjetivo: Este estudo prospectivo visou investigar fatores preditivos para a hiperidrose compensatória após a simpatectomia toracoscópica. Métodos: De 2000 a 2002, 80 pacientes (53 mulheres e 27 homens), com idade entre 12 e 56 anos, foram submetidos à simpatectomia toracoscópica para o tratamento de hiperidrose e acompanhados em média por 42,51 ± 5,98 meses. A satisfação destes pacientes quanto aos resultados do procedimento foi aferida por meio de uma escala de avaliação. O procedimento foi executado bilateralmente: no nível de T2 para a hiperidrose facial; de T3 e T4 para a hiperidrose axilar; e de T3 para a hiperidrose palmar. Resultados: No período pós-operatório, 68 pacientes (85,0%) apresentaram hiperidrose compensatória, que foi classificada como leve em 23 (33,85%), moderada em 23 (33,8%) e grave em 22 (32,4%). Quanto aos resultados da cirurgia, na avaliação dos pacientes, 70 deles (87,5%) se consideraram satisfeitos, enquanto 10 pacientes (12,5%) disseram estar insatisfeitos. O grau de satisfação do paciente variou de acordo com o sexo, a idade, o índice de massa corpórea (IMC) e a extensão da operação. A hiperidrose compensatória foi mais intensa no abdome e dorso do que nas pernas. Conclusões: Embora a hiperidrose compensatória seja um efeito adverso frequente após a simpatectomia, o grau de satisfação dos pacientes foi elevado. Os melhores candidatos para simpatectomia toracoscópica são mulheres adultas jovens com IMC ≤ 24,9 kg/m 2 .

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Compensatory sweating after thoracoscopic sympathectomy: characteristics, prevalence and influence on patient satisfaction

et al. 2009

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“…Segue abaixo tabela comparativa dos níveis de ressecção e incidência de sudorese reflexa encontradas durante revisão da literatura 7,27,28 Seu mecanismo fisiopatológico é bem complexo, mas acredita-se que a simpatectomia em um nível mais alto, T2, bloquearia o feedback negativo dos estímulos aferentes ao hipotálamo por interrupção de praticamente todas as vias aferentes. Em consequência, uma contínua liberação de estímulos eferentes pelo hipotálamo induziria um suor compensatório.…”

Section: Discussionunclassified

“…Como forma de minimizar a incidência de hiperidrose reflexa, defende-se a realização de simpatectomia em apenas um dos gânglios de cadeia simpática torácica e no nível anatômico mais inferior 7 .…”

Section: Introductionunclassified

A sudorese compensatória e sua correlação com os níveis de ressecção ganglionar na simpatectomia para hiperidrose : revisão de literatura / Compensatory sweating and its correlation with lymph node resection levels in sympathectomy for hyperhidrosis: literature review

Almeida¹,

Moraes²

2022

Braz. J. Hea. Rev.

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Conceitua-se hiperidrose a produção excessiva de suor por hiperfunção das glândulas écrinas que fazem parte do sistema de regulação da termostase corporal. Classifica-se como primária ou secundária, focal ou generalizada. Há modalidades de tratamento cirúrgicos e não cirúrgicos que variam em eficácia terapêutica, duração do efeito, custo e efeitos colaterais. Atualmente a simpatectomia videotoracoscópica é considerada o tratamento de eleição pelos melhores resultados obtidos. Nota-se relação entre o número de gânglios ressecados e o nível de secção da cadeia simpática com a ocorrência de sudorese compensatória.

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“…In the past, upper thoracic sympathectomy required a supraclavicular approach with possibility of injury of cervical structures or bilateral thoracotomies and therefore it was rarely offered, however; at present the endoscopic approach becomes the preferred treatment of primary palmar hyperhydrosis once the secondary causes have been rolled out (1)(2)(3). It is considered now the procedure of choice as it is easy and safe in addition; the complications which are normally associated with the conventional approach can be avoided by the endoscopic one because of the superior view achieved with the video-telescope system (4).There is a controversy between the need for resection of the sympathetic trunk versus other procedures such as electro-coagulation, cryo-coagulation, destruction by radio-frequency, the use of harmonic scalpel, laser ablation or sympathetic trunk interruption by titanium clips (5)(6). In the present study the outcome of endoscopic thoracic sympathectomy performed by resection and thermal ablation techniques are compared.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Thoracic Sympathectomy : A Comparative Study of Resection and Electro-Diathermy Ablation in the Treatment of Primary Palmar Hyperhidrosis : Taif Experience

السعيد¹,

حاتم²,

Mourgi³

2013

EJHM

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Background and aim of the work: Palmar Hyperhidrosis is an excessive and unpleasant sweating and it is under control of the thoracic sympathetic chain. At present, endoscopic upper thoracic Sympathectomy (ETS) offers a safe and durable solution of the condition. The operation includes excision, electro diathermy ablation or application of surgical clips on the thoracic sympathetic ganglia T2 and T3. The present study was done to compare the results achieved by excision and electro-diathermy ablation. Patients and methods: This prospective randomized study was conducted in King Abdul Aziz Specialist Hospital and Al-Hada Armed Forces Hospital, Taif-Saudi Arabia, from January 2007 to August 2010 and included sixteen patients with primary palmar hyperhidrosis. They were randomized into 2 groups; each of 8 patients. In one group; the sympathetic chains with T2 and T3 ganglia were excised on both sides and in the other group, the sympathetic chains and ganglia were ablated bilaterally using electro-coagulation diathermy hook. Results: There were 10 women and six men. The mean age of the ablation group was 23.6±7.6 years and in the resection group it was 22.5±8.4years. The mean operating time for bilateral Sympathectomy in the resection group was 74±18.6minutes; whilst in the thermal ablation group it was 32±7.8 minutes. The mean postoperative hospital stay in the excision group was 48±12 hours and in the ablation group, it was24±6 hours. No deaths occurred and all patients are discharged with dry hands. The mean follow up was 24±18 months. Intraoperative intercostal venous bleeding occurred in 18.75% of sympathectomies in the excision group but not in the ablation group. Neuralgic pain of the chest wall developed in 31.25% of sympathectomies of the excision group and 6.25% of the sympathectomies of the ablation group. Horner's syndrome developed in 6.25% per cent of the sympathectomies in both groups. Compensatory hyperhidrosis of trunk and thighs occurred in 37.5% of both groups. Recurrence developed in 6.25% of ablation group but no recurrence in the excision group. Conclusion: The rate of recurrence after endoscopic thoracic sympathectomy for treatment of primary palmar hyperhydrosis, if ablation is used, may be higher than resection, however; it is practically accepted as the procedure is easier, has shorter operating time with less liability to develop neuralgic pain and intercostal venous bleeding.

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Simpatectomia torácica por videotoracoscopia

Cited by 5 publications

References 4 publications

Compensatory sweating after thoracoscopic sympathectomy: characteristics, prevalence and influence on patient satisfaction

Compensatory sweating after thoracoscopic sympathectomy: characteristics, prevalence and influence on patient satisfaction

A sudorese compensatória e sua correlação com os níveis de ressecção ganglionar na simpatectomia para hiperidrose : revisão de literatura / Compensatory sweating and its correlation with lymph node resection levels in sympathectomy for hyperhidrosis: literature review

Endoscopic Thoracic Sympathectomy : A Comparative Study of Resection and Electro-Diathermy Ablation in the Treatment of Primary Palmar Hyperhidrosis : Taif Experience

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