Single‐Port Endoscopic Thoracic Sympathectomy with Monitored Anesthesia Care: A More Promising Procedure for Palmar Hyperhidrosis

Ye, Ning; Wang, Yanan; Tao, Xiandong; Tang, Hua; Jiang, Jingjing; Li, Yonghua; Sun, Guangyuan; Xue, Lijun; Zhao, Xuewei

doi:10.1007/s00268-015-3104-7

Cited by 8 publications

(8 citation statements)

References 29 publications

(32 reference statements)

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“…The NiVATS procedures were performed as uniportal surgeries, while the VATS operations were done with two ports. Successful uniportal, thoracoscopic sympathectomies are already described in case reports and case series [10,18]. Puncturing the vagal nerve is the most unusual procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Intrathoracic vagal block by infiltration of bupivacaine or ropivacaine near the vagal nerve is necessary to inhibit the cough reflex during thoracoscopic manipulation of the lung [8,9]. Several studies have described the feasibility, safety and effectiveness of NiVATS sympathectomy for primary hyperhidrosis [9,10]. So far, only Elia and colleagues have compared NiVATS sympathectomy with sympathectomy under general anaesthesia [9].…”

Section: Introductionmentioning

confidence: 99%

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Establishing a non-intubated thoracoscopic surgery programme for bilateral uniportal sympathectomy

et al. 2019

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AIM OF THE STUDY: Non-intubated, video-assisted thoracoscopic surgery (NiVATS) has been successfully developed in several centres worldwide. Local anaesthesia techniques and techniques to perform thoracoscopic surgery on a spontaneously breathing lung are the two key elements which must be adopted to establish a NiVATS programme. We established NiVATS by performing bilateral, uniportal sympathectomies, and compared it to classical video-assisted thoracoscopic surgery (VATS) under general anaesthesia with double-lumen intubation.METHODS: Ten consecutive bilateral VATS sympathectomies were compared with ten consecutive NiVATS procedures. Nineteen of the procedures were for palmar hyperhidrosis and one was for facial blushing. Duration of anaesthesia, surgery and hospitalisation, perioperative complications, side effects and quality of life before and after sympathectomy were analysed. RESULTS: Median age was 26.5 years (range 17-55) and mean BMI in the NiVATS group was 21.8 (range 19.1-26.3). NiVATS sympathectomies were performed as outpatient procedures significantly more often (9/10 vs 3/ 10, p = 0.008). Quality of life was significantly increased after sympathectomy in all patients, with no significant differences between the NiVATS and the VATS groups. There were no differences between the two groups regarding compensatory sweating (40 vs 50%, p = 0.66). The duration of anaesthesia, not including the time required for the surgery, was significantly shorter in the Ni-VATS group (p <0.001). The duration of surgery, from the first local anaesthesia until the last skin suture, was significantly longer in the NiVATS group (p = 0.04), but showed a constant decline during the learning curve, from 95 minutes initially to 48 minutes for the last procedure. Costs were significantly lower in the NiVATS group (p = 0.04).CONCLUSION: Thoracoscopic sympathectomy is a suitable procedure with which to establish a NiVATS programme. Patients are usually young and of healthy weight, facilitating the learning curve for the local anaesthesia techniques and the surgery. Compared to VATS, sympathectomy is more likely to be performed as an outpatient procedure and has a lower cost, while safety and efficacy are maintained.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Establishing a non-intubated thoracoscopic surgery programme for bilateral uniportal sympathectomy

et al. 2019

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“…Recently, VATS procedures without tracheal intubation were reported to be feasible and well tolerated for management of pneumothorax, sympathectomy, wedge resection of pulmonary tumours, lung volume reduction surgery, segmentectomy, and lobectomy [21][22][23][24][25][26]. Patients undergoing nonintubated VATS were anaesthetized using regional anaesthesia in a spontaneously single lung breathing status after iatrogenic open pneumothorax [27][28][29].…”

Section: Anaesthetic Techniquementioning

confidence: 99%

Fast track in thoracic surgery and anaesthesia

Loop

2016

Current Opinion in Anaesthesiology

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“…In recent years, non-endotracheal intubation VATS has been reported to be feasible and well-tolerated in the treatment of pneumothorax, sympathetic nerve resection, wedge resection of lung tumor, lung volume reduction surgery, segmentectomy, and lobectomy. [38][39][40][41] Early results of non-intubated general anesthesia include faster postoperative recovery and a lower incidence of complications compared to general anesthesia for double-lumen bronchial intubation, which may translate into a fast-track VATS program. However, in the current situation of shortage of anesthesiologists in China, it is difficult to carry out this technique on a large scale, because non-intubation general anesthesia requires anesthesiologists to pay attention to airway management all the time and give more energy.…”

Section: Intra-operative Factorsmentioning

confidence: 99%

Thirty Days Mortality Following Lung Resection: Risk Factors, Preoperative Assessment and Improvement Program

Wang¹,

Sun²,

Abby³

et al. 2019

JAH

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Effect and mechanism of acute graft versus host disease on early diffuse murine lung injury following allogeneic stem cell transplantation Science in China Series C-Life Sciences 52, 1016 (2009); An efficient method for identification of risk factors Science in China Series E-Technological Sciences 52, 3626 (2009); Risk assessment method of major unsafe hydroelectric project Science in China Series E-Technological Sciences 51, 1345 (2008); Dynamic security risk assessment and optimization of power transmission system Science in China Series E-Technological Sciences 51, 713 (2008);

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Single‐Port Endoscopic Thoracic Sympathectomy with Monitored Anesthesia Care: A More Promising Procedure for Palmar Hyperhidrosis

Abstract: Single-port ETS with flexible thoracoscopy under monitored anesthesia is a promising procedure for palmar hyperhidrosis.

Cited by 8 publications

References 29 publications

Establishing a non-intubated thoracoscopic surgery programme for bilateral uniportal sympathectomy

Establishing a non-intubated thoracoscopic surgery programme for bilateral uniportal sympathectomy

Fast track in thoracic surgery and anaesthesia

Thirty Days Mortality Following Lung Resection: Risk Factors, Preoperative Assessment and Improvement Program

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