Repeat transthoracic endoscopic sympathectomy for palmar and axillary hyperhidrosis

Abstract

Repeat TES is a safe and effective method for treating both an unsuccessful sympathectomy and recurrent palmar or axillary hyperhidrosis.

Limited endoscopic thoracic sympathetic block for hyperhidrosis of the upper limb: reduction of compensatory sweatng by clipping T4

“…Moreover, no recurrences have been observed in the ESB 4 group. Other authors have demonstrated that resympathicotomy for recurrence can be performed with good results [13,14].…”

“…The level of transsection usually comprised T2-T3/T4 for palmar hyperhidrosis [4,17], and it was assumed that T4 or even T5 should be included in cases of axillary hyperhidrosis [8,16,17]. For palmar hyperhidrosis, limited sympathicotomy has been recommended ranging from T2 and T3 transsection to T2 or T3 severance [1,5,7,8,14,20]. Likewise, a variety of transsection levels have been proposed for axillary hyperhidrosis, ranging from T2 to T5 at different combinations [7,8,12,14,16].…”

Needlescopic thoracic sympathetic block by clipping for craniofacial hyperhidrosis

“…In our experience, there is no sloughing of the endo clips after the clipping method. Another bene®t of sympathetic block by clipping is that it is safer than ETS in patients where the sympathetic trunk is close to a vessel [8,10]. In addition, it obviates the induction of cardiac arrhythmia by electric stimulation from the diathermy probe because no electrocautery is ever applied to the sympathetic trunk itself [5,6,8].…”

Simpatectomía toracoscópica: una revisión de la literatura

“…Habitualmente aparece con el calor o el ejercicio sobre tórax, abdomen y muslos. En general, es bien tolerada y dismi-nuye en los siguientes meses 2,18,32,40,48,49,50,51,66 .…”

“…En pacientes con hiperhidrosis palmar, que es la indicación más frecuente, suele llevarse a cabo una lesión del ganglio simpático T2, que puede extenderse hasta los ganglios T3 y T4, aunque la mayoría de los autores coinciden en que no es necesario salvo hiperhidrosis axilar asociada, ya que podría incrementar la tasa y el grado de hiperhidrosis compensatoria y la sequedad de las manos 18,49,51 .…”