Normativa sobre Cirugía del Sistema Nervioso Simpático Torácico

Early and Midterm Results of Single-Port Video-Assisted Thoracoscopic Sympathectomy

“…Recurrence of hyperhidrosis was reported in 1 to 27% of the cases after thoracoscopic sympathectomy. 14,15 In the present study it was observed in three patients, although the sympathetic trunk could be identified intraoperatively. The existence of the Kuntz nerve and accessory pathways has been classically reported as a cause of therapeutic failure in palmar hyperhidrosis.…”

“…In a few patients, pleural effusion, or chylothorax can occur. 14,15 It is recommended to insert a pleural drain to evacuate the pneumothorax generated after thoracoscopic sympathectomy. 15 However, there are no concerns between the surgeons.…”

“…Recurrences of hyperhidrosis have been related with surgeon experience, anatomical variations, and incomplete interruption of the sympathetic chain or possible nerve regeneration. 15 The potential advantages of a single-port approach are the involvement of only one intercostal space with possible reduction of postoperative pain. Incidence of chronic pain was reported ranges from 0 to 20%.…”

Single-Port Thoracoscopic Sympathicotomy Using a Double-Lumen Electrocautery Tube and Cautery Hook for Primary Palmar Hyperhidrosis: A Randomized Controlled Trial

“…Surgery of the thoracic sympathetic nervous system (SNS) to improve the circulation of the upper limbs has been performed since the beginning of the 20th century. 1 Since 1990, video-assisted thoracoscopic sympathectomy for PPH has replaced open surgery with the advantages of shorter hospital stay, lower morbidity rates, less pain, and better cosmetic results. 8,9 In an attempt to reduce postoperative compensatory sweating it is generally recommended that the sympathetic chain is ablated at the T3 and/or T4 level.…”

“…There are several options for interrupting the sympathetic nervous system (SNS), and each appears to be equally effective. 1 Ablation of the sympathetic nerve chain can be performed by cutting over the ribs (sympathicotomy), ganglia resection (sympathecotomy), or it can be undertaken by ramicotomy. These are all permanent techniques.…”