New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis

Han, Jung Wook; Kim, Jae Jun; Kim, Yong Hwan; Kim, In Sub; Jeong, Seong Cheol

doi:10.21037/jtd.2019.12.91

Cited by 15 publications

(21 citation statements)

References 30 publications

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“…We chose hydrophilic SP‐A which has innate immune functions against respiratory pathogens such as influenza A virus and hydrophobic SP‐B essentially required for breathing. [ 32 ] As seen in Figure 6h,i, marked differences were observed among the groups with the highest gene expressions in the 3D structured model. As expected, classical 2D‐grown monolayers of alveolar cells resulted in lower expression levels in most of the genes compared to in 3D microenvironments.…”

Section: Resultsmentioning

confidence: 91%

All‐Inkjet‐Printed 3D Alveolar Barrier Model with Physiologically Relevant Microarchitecture

et al. 2021

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With the outbreak of new respiratory viruses and high mortality rates of pulmonary diseases, physiologically relevant models of human respiratory system are urgently needed to study disease pathogenesis, drug efficacy, and pharmaceutics. In this paper, a 3D alveolar barrier model fabricated by printing four human alveolar cell lines, namely, type I and II alveolar cells (NCI-H1703 and NCI-H441), lung fibroblasts (MRC5), and lung microvascular endothelial cells (HULEC-5a) is presented. Automated high-resolution deposition of alveolar cells by drop-on-demand inkjet printing enables to fabricate a three-layered alveolar barrier model with an unprecedented thickness of ≈10 µm. The results show that the 3D structured model better recapitulate the structure, morphologies, and functions of the lung tissue, compared not only to a conventional 2D cell culture model, as expected, but also a 3D non-structured model of a homogeneous mixture of the alveolar cells and collagen. Finally, it is demonstrated that this thin multilayered model reproduce practical tissue-level responses to influenza infection. Drop-on-demand inkjet-printing is an enabling technology for customization, scalable manufacturing, and standardization of their size and growth, and it is believed that this 3D alveolar barrier model can be used as an alternative to traditional test models for pathological and pharmaceutical applications.

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Section: Resultsmentioning

confidence: 91%

All‐Inkjet‐Printed 3D Alveolar Barrier Model with Physiologically Relevant Microarchitecture

et al. 2021

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“…The most common complication in both techniques was compensatory hyperhidrosis (CH), in the form of increased sweating of the back [16]. CH was more common in the surgical technique compared to the radiofrequency ablation.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic excision versus radiofrequency ablation of the sympathetic chain as a treatment for palmar hyperhidrosis: comparative study

et al. 2020

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Background: Hyperhidrosis is an excess sweat secretion. Various modalities of treatment exist for hyperhidrosis. Although medical treatment is the first line of treatment, its long-term outcome is not satisfactory. In this study, we compared the results of thoracoscopic excision with that of radiofrequency ablation of the sympathetic chain as a treatment of palmar hyperhidrosis. Results: During the period from January 2014 to December 2017, 42 patients with palmar hyperhidrosis after failure of medical treatment presented to Departments of Pediatric Surgery and Neurosurgery, Faculty of Medicine. They were 26 males and 16 females. Their ages ranged between 11 and 42 years (mean 21.78 years). Twenty patients underwent thoracoscopic excision of the sympathetic chain (in Pediatric Surgery Department), while 22 patients underwent radiofrequency ablation of the sympathetic chain (in Neurosurgery Department). For the thoracoscopic sympathectomy group, the mean operative time was 27.39 min, the mean length of hospital stay was 24.78 h, the mean sweating scale decreased from 3.28 preoperatively to 1.33 1 year postoperatively, and the main postoperative complication was compensatory hyperhidrosis (40%). For the radiofrequency ablation group, the mean operative time was 55 min, the mean length of hospital stay was 20.64 h, the mean sweating scale decreased from 3.29 preoperatively to 1.57 1 year postoperatively, and the main postoperative complication was recurrence of hyperhidrosis (27%). Conclusion: Thoracoscopic excision is more effective than radiofrequency ablation of the sympathetic chain in improving palmar hyperhidrosis. However, it has a higher risk of developing compensatory hyperhidrosis.

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“…Effects of lower thoracic sympathicotomy on plantar hyperhidrosis Seong Cheol Jeong 1 , Jae Jun Kim 1 , In Sub Kim 1 , Yong Hwan Kim 1 , Jung Wook Han 1 , Seok Whan Moon 2 effective treatment modality for PH that is refractory to conservative treatment (1,3,4). Usually, the upper thoracic sympathetic levels ranging from T2 to T5 by various methods are blocked according to the hyperhidrosis type, patient condition, and surgeon preference (5)(6)(7).…”

Section: Original Articlementioning

confidence: 99%

“…When the level of sympathicotomy included both R3 and R4, we considered these cases as R3 sympathicotomy. In the cases of expanded thoracic sympathicotomy, patients were put under general anesthesia with single lumen endotracheal anesthesia in the prone position, underwent a 5-mm, two-port endoscopic sympathicotomy using a CO 2 gas insufflation via the sixth intercostal space on the mid-axillary line and the seventh intercostal space on the post-axillary line (2). We expanded the level of sympathicotomy ranging from R5 to R12 in addition to the conventional upper thoracic sympathicotomy (level of R3 or R4).…”

Section: Study Participants and Procedures For Sympathetic Blockagementioning

confidence: 99%

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Effects of lower thoracic sympathicotomy on plantar hyperhidrosis

Jeong

Kim

et al. 2021

J Thorac Dis

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Background: The purpose of this study was to investigate whether performing lower thoracic sympathicotomy (LTS) from T10 to T12 affects plantar hyperhidrosis in patients with palmo-plantar (PP) or palmo-axillary-plantar (PAP) hyperhidrosis. Methods: Between January 2015 and January 2020, all consecutive patients with primary hyperhidrosis who underwent bilateral thoracoscopic sympathicotomy and met the inclusion criteria were included.Sympathicotomy was performed using one of the following two methods: the conventional upper thoracic vs. expanded thoracic sympathicotomy. In the expanded thoracic sympathicotomy, we expanded the level of sympathicotomy ranging from R5 to R12 in addition to the conventional upper thoracic sympathicotomy (R3 or R4). In cases of the expanded thoracic sympathicotomy, we defined the LTS as a sympathicotomy of the levels ranging from R10 to R12, which are related to plantar hyperhidrosis. Results: A total of 103 subjects with PP (71 cases) or PAP (32 cases) hyperhidrosis were included. Palmar or axillary hyperhidrosis in all patients were alleviated after sympathicotomy. There was no difference in sweating decrease or CH according to the hyperhidrosis types or sympathicotomy techniques. In addition, no-LTS was performed in 77 cases and LTS was performed in 26 cases. In the no-LTS group, there were 65 and 12 cases of low and high degrees of CH, respectively. In the LTS group, there were 22 and four cases of low and high degrees of CH, respectively. There was no significant difference in CH between the no-LTS and LTS groups (P=0.981). Improvement in plantar hyperhidrosis in the no-LTS group was observed in 29 of 77 cases, while improvement in plantar hyperhidrosis in the LTS group was observed in 16 of 26 cases. The addition of LTS lead to significant improvement in plantar hyperhidrosis (P=0.034).Conclusions: Performing LTS is a safe and feasible procedure that improved plantar sweating more so than it did in cases that did not undergo LTS. Therefore, we cautiously suggest that adding LTS helps in the treatment of plantar hyperhidrosis combined with palmar hyperhidrosis. Further studies on LTS are needed to validate these findings and will be helpful in establishing management guidelines.

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New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis

Cited by 15 publications

References 30 publications

All‐Inkjet‐Printed 3D Alveolar Barrier Model with Physiologically Relevant Microarchitecture

All‐Inkjet‐Printed 3D Alveolar Barrier Model with Physiologically Relevant Microarchitecture

Thoracoscopic excision versus radiofrequency ablation of the sympathetic chain as a treatment for palmar hyperhidrosis: comparative study

Effects of lower thoracic sympathicotomy on plantar hyperhidrosis

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