Axillary transpleural sympathectomy: Indication, technique, and results

Linder, F; Jenal, G.; Assmus, Hans

doi:10.1007/bf01658097

Cited by 19 publications

(9 citation statements)

References 4 publications

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“…69,70 An extrapleural transaxillary approach with resection of the first rib has also been described. 71 Bilateral sympathectomy by this approach was usually performed as a staged procedure and the results reported in several series 16,[72][73][74] are similar to those of the other surgical methods.…”

Section: Open Sympathectomysupporting

confidence: 61%

The treatment of primary palmar hyperhidrosis: A review

2000

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Primary palmar hyperhidrosis (HH) is a pathological condition of overperspiration caused by excessive secretion of the eccrine sweat glands, the etiology of which is unknown. This disorder affects a small but significant proportion of the young population all over the world. Neither systemic nor topical drugs have been found to satisfactorily alleviate the symptoms. Although the topical injection of botulinum has recently been reported to reduce the amount of local perspiration, long-term results are required before a definitive evaluation of this method can be made. Hypnosis, psychotherapy, and biofeedback have been beneficial in a limited-number of cases. While radiation achieves atrophy of the sweat glands, its detrimental effects prohibit its use. Iontophoresis has attained some satisfactory results but it has not been assessed long term. Percutaneous computed tomography-guided phenol sympathicolysis achieves excellent immediate results, but its long-term failure rate is prohibitive. Furthermore, percutaneous radiofrequency sympathicolysis may be an effective procedure, but its long-term results are not superior to surgical sympathectomy. On the other hand, surgical upper dorsal (T2-T3) sympathectomy achieves excellent long-term results and the thoracoscopic approach has supplanted the open procedures. Despite some sequelae, mainly in the form of neuralgia and compensatory sweating which cannot be predicted and may be distressing, surgical sympathectomy remains the best treatment for palmar hyperhidrosis.

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Section: Open Sympathectomysupporting

confidence: 61%

The treatment of primary palmar hyperhidrosis: A review

2000

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“…Although various methods of sympathetic surgery have been proposed [1,5,14,16,22], the endoscopic procedure currently remains the most popular and acceptable method. The reasons derive from its simplicity, safety, and efficacy [3,9,10].…”

mentioning

confidence: 99%

The importance of classification in sympathetic surgery and a proposed mechanism for compensatory hyperhidrosis: experience with 464 cases

et al. 2006

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“…Although Linder et al [31] observed 80 % longterm improvement in patients with Raynaud's disease, other large series showed failure of sympathectomy in two thirds of patients within a year [11] and in a total of up to 81 % of cases [10]. Based on these results, sympathectomy should be reserved mainly for cases with imminent tissue loss or established ulcers.…”

Section: S Evaluation Based On Results According To Indicationsmentioning

confidence: 97%

“…Regarding recurrence of hyperhidrosis, all three accesses (posterior [8,17,43], supraclavicular [6,9,20,27,46], and transaxillary [12,22,31,47]) have a high long-term success rate (more than 90 %), without significant difference between the techniques. The choice of surgical approach should, therefore, be based on factors other than the success rate of the operative technique.…”

Section: I/12mentioning

confidence: 98%

“…It consists of increased perspiration in other parts of the body, and appears in a large proportion of patients [20,31,42]. It is considered usually to be a compensatory thermoregulating mechanism [13,42], namely that the total body amount of perspiration is unchanged by sympathectomy while the sweating area is diminished [44].…”

Section: S Evaluation Based On Postoperative Sequelsmentioning

confidence: 99%

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Upper thoracic sympathetic surgery

Kopelman

Hashmonai

2003

Clinical Autonomic Research

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Four open surgical approaches have been used to perform upper thoracic sympathectomy. The posterior approach requires access through the posterior muscles of the back, and rib transection. It is a painful operation that has been practically abandoned in favor of the other techniques. The anterior transthoracic approach consists of a formal thoracotomy and never gained popularity. The supraclavicular approach involves dissection of several important anatomical structures. It requires excellent surgical dexterity, but ensures the easiest postoperative recovery. The last approach involves a small transaxillary thoracotomy. Technically, it is the easier procedure. Both the supraclavicular and the transaxillary approaches were widely used until the advent of thoracoscopic surgery. The results (rate of success, recurrences, and sequelae) were similar for all techniques, depending on the procedure performed on the sympathetic chain, not on the access route. Open approaches for upper dorsal sympathectomy are not used any more except in the very rare cases in which thoracoscopy is unfeasible.

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Axillary transpleural sympathectomy: Indication, technique, and results

Cited by 19 publications

References 4 publications

The treatment of primary palmar hyperhidrosis: A review

The treatment of primary palmar hyperhidrosis: A review

The importance of classification in sympathetic surgery and a proposed mechanism for compensatory hyperhidrosis: experience with 464 cases

Upper thoracic sympathetic surgery

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