Needle thoracic sympathectomy for essential hyperhidrosis: intermediate-term follow-up

Results, side effects and complications after thoracoscopic sympathetic block by clamping

“…Our results suggest that the use of a minimally disruptive surgical procedures (i.e., clamping) reduces the degree of compensatory sweating to 22%, much lower than reported in other studies [6,18,22,23,26,27]. We did not demonstrate a correlation between extent of sympathectomy and the degree of compensatory sweating [18].…”

T2–T4 sympathectomy versus T3–T4 sympathicotomy for palmar and axillary hyperhidrosis

“…Otherwise, it was suggested that the onset of compensatory hyperhidrosis could be reduced by minimizing damage on the ganglionic chain. Gothberg in 1994, and then Lee and Rex in two different works in 1998, began to treat palmar and axillary hyperhidrosis with the only section of the ganglionic chain (sympathicotomy) with similar effectiveness to sympathectomy [16][17][18]. The theoretic background of sympathectomy is based on the anatomical distribution of the autonomic nerve fibres, responsible for the innervation of palms and fingers.…”

“…The decision to cut below the lower margin of the 2nd rib increases the risk of developing the most alarming complication of this type of surgery, which is the ClaudeBernard-Horner syndrome. To prevent this risk, several authors have suggested to perform the section at a more caudal level, corresponding to the inferior margin of the III rib where the 3rd thoracic ganglion is located [17].…”

Incidence of chest wall paresthesia after needlescopic video-assisted thoracic surgery for palmar hyperhidrosis☆

“…One recent strategy to improve on the results of VATS is needlescopic VATS (n-VATS) [13][14][15][16][17]. In this technique, the 10 mm sized ports and instruments of conventional VATS (c-VATS) are replaced by very fine 2 or 3 mm instruments.…”