T3 versus T4 video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis

Abstract

Background:Palmar hyperhidrosis (PH) is a common sympathetic disorder that reduces patient’ quality of life. Video-assisted thoracoscopic sympathectomy (VTS) is a popular and effective treatment for PH. However, there is substantial controversy about the treatment of PH with VTS at the T3 or T4 level. We will compare the quality metrics of VTS at T3 versus T4 to determine the optimal level for VTS.Methods:We will search PubMed, Scopus, Web of Science, Embase, Cancerlit, the Cochrane Central Register of Controlled Trials, and the Google Scholar databases for relevant clinical trials published in any language before March 31, 2019. Randomized controlled trials (RCTs), quasi-RCTs, propensity score-matched comparative studies, and prospective cohort studies of interest, published or unpublished, that meet the inclusion criteria will be included. Subgroup analysis of the type of operation, sex of patient, and ethnicity of patient will be performed.Results:The results of this study will be published in a peer-reviewed journal.Conclusions:The results of this study will provide reliable evidence for the development of optimal treatment strategies for patients with PH. Owing to the characteristics of disease and intervention methods, randomized controlled trials may not be sufficient. We will include high-quality nonrandomized controlled trials, but this may lead to high heterogeneity and may affect the reliability of the results.PROSPERO registration number:CRD42018116607.

Estandarización de una técnica en el tiempo y su impacto en los resultados para hiperhidrosis palmar primaria

“…El tiempo quirúrgico es la variable que mayor evidencia aporta en cuanto la simplicidad técnica. Una media de 14 min para ambos hemitórax, mejora notablemente los resultados respecto a series revisadas y a nuestras series anteriores 17,18 .…”

Bilateral endoscopic thoracic sympathectomy via single incision for the treatment of palmar and axillar hyperhidrosis

“…In a prospective comparison study about using two ports or a single port in VATS for palmar hyperhidrosis, both procedures were found to be safe and minimally invasive. While single port method found out to be less painful, so it was should be preferred [14]. We also used a single port in all of our operations and received positive feedbacks from patients on lesser postoperative pain.…”

Single-port bilateral endoscopic thoracic sympathectomy for the treatment of hyperhidrosis

“…Geleneksel cerrahi yerine torakoskopik yaklaşımı tercih etmek ve ilave port kesisinden kaçınmak daha az kas dokusu ve interkostal sinir hasarına neden olur. Bu durum ameliyat sonrası ağrının şiddet ve süresinin azalmasına, yüksek hasta memnuniyetine ve hastanın daha hızlı bir şekilde tam aktiviteye dönmesine yardımcı olur (12)(13)(14). Çalışmamızda hiperhidrozisin tedavisi için tüm hastalarda tek port tekniği kullanıldı ve düşük ağrı skorları (24. saat VAS ağrı skoru: ortalama 3.2) elde edildi.…”