Thoracoscopic sympathectomy ganglia ablation in the management of palmer hyperhidrosis: A decade experience in a single institution

Kravarušić, Dragan; Freud, Enrique

doi:10.4103/0189-6725.99402

Cited by 7 publications

(9 citation statements)

References 23 publications

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“…No painful stress was present in our patients as we infiltrated the tissues with bupivacaine (19) up to the endothoracic fascia before skin incision for placement of the trocar and nonsteroidal antiinflammatory agents were given postoperatively. Other complications of the procedure are reported as pneumothorax, intrathoracic bleeding, and gustatory sweating (2,4,5,20,21). In our series one patient required insertion of a chest tube due to pneumothorax.…”

Section: Discussionmentioning

confidence: 61%

“…VTS with 2 or 3 small incisions is the most common technique used. The single port VTS is a novelty having excellent cosmetic results and improved satisfaction (2,11,16,17). We have been using this single port technique for all age groups with similar advantages for the last 2 years.…”

Section: Discussionmentioning

confidence: 99%

“…There is still no consensus about the mechanism of hyperhidrosis in adolescents. The prevalence is reported as 0.6%-1.0% in young populations (2).…”

Section: Introductionmentioning

confidence: 99%

“…Thoracoscopic sympathectomy, which is accepted as the gold standard for the permanent cure of PFH, is achieved by interruption of impulse transmission from sympathetic ganglia to the sweat glands (2,3). A few studies reported that surgery should be performed before adulthood, emphasizing that adolescents tolerate side effects better than adults (1,(3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

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Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

Günal¹,

Özpolat²,

Günal³

et al. 2014

Turk J Med Sci

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IntroductionHyperhidrosis is a health problem having negative effects on adolescent quality of life, affecting daily social activities or educational life. Primary focal hyperhidrosis (PFH) is often observed in axillary, palmar, plantar, and craniofacial regions and more than one region can be involved (1). There is still no consensus about the mechanism of hyperhidrosis in adolescents. The prevalence is reported as 0.6%-1.0% in young populations (2).Thoracoscopic sympathectomy, which is accepted as the gold standard for the permanent cure of PFH, is achieved by interruption of impulse transmission from sympathetic ganglia to the sweat glands (2,3). A few studies reported that surgery should be performed before adulthood, emphasizing that adolescents tolerate side effects better than adults (1,3-7).Among adolescents, primary palmar hyperhidrosis (PPH) is widely disregarded and undertreated. To the best of our knowledge, there is no study reporting PPH treatment with single port video-assisted thoracoscopic sympathectomy (VTS) in adolescents in Turkey. Herein, we report our experience and short-term outcomes of this treatment, where the symptom resolution, intraoperative and postoperative complications, patient satisfaction, and subsequent compensatory sweating (CS) are analyzed. Materials and methodsSeven adolescents who underwent VTS for PPH between March 2011 and July 2012 were included. The indications for operation in our patients were chosen according to the Multi-Specialty Working Group on the Recognition, Diagnosis, and Treatment of Primary Focal Hyperhidrosis criteria: focal, visible, excessive sweating of at least 6 months in duration without an underlying cause, plus at least 2 of the following characteristics: a distribution that is bilateral and relatively symmetric, impairment of daily activities, at least 1 episode per week, onset before 25 years of age, family history of PFH, or focal sweating that ceases during sleep (8).Data were collected retrospectively. The chief complaint of patients was palmar hyperhidrosis. Additional axillary hyperhidrosis was present in 6 patientsAim: Hyperhidrosis is defined as excessive sweating beyond the physiologic needs of a person. Palmar hyperhidrosis in the adolescent period may have an impact on school work and may cause psychological problems. In this study we aim to increase awareness of this disregarded problem. Materials and methods:We explicated the early outcomes of 7 consecutive adolescents, where single port video-assisted thoracoscopic sympathectomy was performed for primary palmar hyperhidrosis. Patients were evaluated for symptom resolution, which was defined as complete dryness, patient satisfaction, operative complications, and compensatory sweating.Results: In total 13 thoracoscopic procedures were done in 7 adolescents, consisting of 4 girls and 3 boys (median age = 16 years). Thoracoscopic sympathectomy achieved immediate complete dryness and all were very satisfied with the outcome of the procedure. Compensatory sweating was defined as mild by 4...

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

“…There is still no consensus about the mechanism of hyperhidrosis in adolescents. The prevalence is reported as 0.6%-1.0% in young populations (2).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

Günal¹,

Özpolat²,

Günal³

et al. 2014

Turk J Med Sci

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“…Injections of botulinum toxin (29-31) for axillary, palmar or plantar hyperhidrosis is efficacious, but entails high costs and pain, in addition to its being potentially linked to possible neurologic side-effects. Surgical procedures (surgical en bloc excision, liposuction or endoscopic thoracic sympathectomy) offer a permanent solution, but are associated with significant and sometimes irreversible side-effects (32)(33)(34)(35). Laser- (36)(37)(38), radiofrequency thermotherapy- (39), and microwave-(40-43) based therapies have been suggested recently as possible treatment modalities, but data on their long-term efficacy, safety and side-effects are still lacking.…”

Section: Discussionmentioning

confidence: 99%

Topical Oxybutynin 10% Gel for the Treatment of Primary Focal Hyperhidrosis: A Randomized Double-blind Placebo-controlled Split Area Study

Artzi¹,

Loizides²,

Zur³

et al. 2017

Acta Derm Venerol

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Limited efficacy, costs, side-effects and complications are issues of concern for most current therapeutic modalities for focal hyperhidrosis. This study evaluated the efficacy of topical oxybutynin 10% gel in treating 61 patients with primary focal hyperhidrosis. The gel was applied to the right or left axilla, palms or soles vs. a placebo compound to the contralateral side for 30 days. A blinded visual grading of the change in starch-iodine tests was performed by 2 non-involved physicians. The Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI) questionnaires were administered before and after treatment. The patients rated their satisfaction with treatment. Fifty-three patients completed the 4-week treatment. Sweat reduction in the drug-treated sweating areas was higher than in the control-treated areas. There was a significant mean improvement in pre- and post-treatment HDSS and DQLI (p = 0.001 for both). Thirty-nine subjects (74%) reported moderate-to-high satisfaction. Twice-daily topical application of oxybutynin 10% gel appears to be an effective, safe and well-tolerated treatment for focal primary hyperhidrosis.

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Over a decade of single-center experience with thoracoscopic sympathicolysis for primary palmar hyperhidrosis: a case series

Mol¹,

Muensterer

2020

Surg Endosc

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Background Primary palmar hyperhidrosis is a severely debilitating condition that can affect patients of any age. We report our experience with thoracoscopic sympathicolysis in a large cohort of children less than 14 years of age. Methods All children who underwent thoracoscopic sympathicolysis from April 2005 through January 2017 were evaluated retrospectively. The procedure entailed bilateral bipolar fulguration of the second and third thoracic ganglia with transverse disruption of collateral nerve fibers along the third and fourth rib. Demographic information, as well as postoperative outcome, complications, and satisfaction were analyzed. Results Over the 12 year study interval, a total of 102 children underwent thoracoscopic sympathicolysis for palmar hyperhidrosis. Complete follow-up was available for 98 patients (median age 12 [range 5–14] years; 38 boys [39%]). Median follow-up was 4 [range 2–12] years. Complete palmar dryness was achieved in 93 (95%) cases. One patient suffered postoperative unilateral ptosis, 6 reported gustatory sweating, and 65 experienced compensatory sweating. Average postoperative rating on a 1 (lowest) to 10 (highest) rating scale was 9, with 97 (99%) patients saying that they would undergo the procedure again. Conclusion Our technique of thoracoscopic sympathicolysis in children was associated with very high postoperative satisfaction, despite a high rate of compensatory sweating and occasional autonomic gustatory sweating. Other more severe complications in this age group were rare.

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Thoracoscopic sympathectomy ganglia ablation in the management of palmer hyperhidrosis: A decade experience in a single institution

Abstract: Thorascopic sympathectomy provides effective and satisfactory cure for palmer hyperhidrosis with acceptable complication rate and excellent satisfactory outcome. There is a possibility of compensatory sweating in some individuals.

Cited by 7 publications

References 23 publications

Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

Topical Oxybutynin 10% Gel for the Treatment of Primary Focal Hyperhidrosis: A Randomized Double-blind Placebo-controlled Split Area Study

Over a decade of single-center experience with thoracoscopic sympathicolysis for primary palmar hyperhidrosis: a case series

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