T2-T3 sympathectomy versus sympathicotomy for essential palmar hyperhidrosis: comparison of effects on cardio-respiratory function

Fiorelli, Alfonso; Daponte, Antonio; Canonico, Raffaele; Palladino, Alberto; Vicidomini, Giovanni; Limongelli, F; Santini, Mario

doi:10.1093/ejcts/ezs071

Cited by 22 publications

(24 citation statements)

References 22 publications

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“…The high success-rates obtained in our study, with a relative low incidence of CHH, strengthens the theory that including the R2 level is not required for adequate PHH relief in any form of isolated palmar or combined palmar/axillary PHH, and is thus better avoided since it heightens the risk for Horner’s Syndrome [21]. It’s also known that a more extensive sympathetic denervation is correlated to a significant higher disturbance in bronchomotor tone and cardiac function, albeit on a sub-clinical level [24]. Perhaps the overlapping conclusion should be that less is more, meaning that lower CHH levels can be achieved by less damage to the sympathetic chain with a more selective sympathicolysis.…”

Section: Discussionmentioning

confidence: 69%

Single-port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach

Kuijpers

Klinkenberg

Bouma

et al. 2013

J Cardiothorac Surg

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BackgroundPrimary palmar and/or axillary focal hyperhidrosis is a frequent disorder characterized by excessive sweating beyond physiological needs, often leading to a substantial impairment of quality of life. Over the years several minimally invasive surgical treatments have been described, however results vary, and due to a lack of uniform surgical approach, technique and nomenclature are often difficult to compare. In this prospective study we sought to evaluate the safety and effectiveness of our standardized technique of single-port, one-stage bilateral thoracoscopic sympathicotomy.MethodsOn a prospective basis a hundred consecutive patients with severe or intolerable primary hyperhidrosis underwent one-stage bilateral single-port thoracoscopic sympathicotomy. Primary outcome was measured in pre- vs. post-operative Hyperhidrosis Disease Severity Scale scores. Location and extend of compensatory hyperhidrosis, and satisfaction with the procedure were registered.ResultsA significant reduction in mean Hyperhidrosis Disease Severity Scale score (3.69 ± 0.47 preoperatively vs. 1.06 ± 0.34 postoperatively) (p < 0.001) was observed. In 97 (97%) out of the 100 enrolled patients a >80% reduction in sweat production was achieved. Compensatory hyperhidrosis was seen in 27 patients (27%). It was rated as mild by 21 patients (78%) and as moderate by 6 (22%) of these patients. No severe compensatory hyperhidrosis was reported. Major complications, such as intraoperative bleeding, infections, and Horner’s syndrome were not observed.ConclusionsHighly selective sympathicotomy at well-defined levels with a one-stage bilateral single-port transaxillary thoracoscopic approach is a save procedure, with excellent and reproducible immediate results in the treatment of primary palmar and/or axillary hyperhidrosis.

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Section: Discussionmentioning

confidence: 69%

Single-port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach

Kuijpers

Klinkenberg

Bouma

et al. 2013

J Cardiothorac Surg

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“…its complete transection, using electrocautery, endoscopic scissors, or other devices. [12][13][14] Furthermore, the sympathetic block is performed using metallic clips, which are applied across the sympathetic nerve without transection. 6 However, the most effective and least invasive surgical approach is not clearly defined.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Miniuniportal Video-Assisted Thoracoscopic Selective Sympathectomy (Ramicotomy) for the Treatment of Severe Palmar and Axillar Hyperhidrosis

Akil¹,

Semik²,

Fischer³

2018

Thorac cardiovasc Surg

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“…Complication rate of Horner's syndrome was higher than that of TES. 23,27 There are four possible reasons for the relatively high incidence of Horner's syndrome in the chemical sympathectomy group:…”

Section: Discussionmentioning

confidence: 99%

CT-Guided Chemical Thoracic Sympathectomy versus Botulinum Toxin Type A Injection for Palmar Hyperhidrosis

Yang

Kang

Zhang

et al. 2018

Thorac cardiovasc Surg

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T2-T3 sympathectomy versus sympathicotomy for essential palmar hyperhidrosis: comparison of effects on cardio-respiratory function

Abstract: Sympathectomy may result in a disturbance of bronchomotor tone and cardiac function. Such changes remained at a sub-clinical level and seemed directly correlated with the extension of denervation.

Cited by 22 publications

References 22 publications

Single-port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach

Single-port one-stage bilateral thoracoscopic sympathicotomy for severe hyperhidrosis: prospective analysis of a standardized approach

Efficacy of Miniuniportal Video-Assisted Thoracoscopic Selective Sympathectomy (Ramicotomy) for the Treatment of Severe Palmar and Axillar Hyperhidrosis

CT-Guided Chemical Thoracic Sympathectomy versus Botulinum Toxin Type A Injection for Palmar Hyperhidrosis

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