Upper extremity sympathectomy

Abstract

Hyperhidrosis is a condition in which there is excessive production of sweat that is disproportional to thermoregulation needs and that profoundly hampers the quality of life (QOL) of the population that is affected by it. The disorder is typically limited to the palms, the plantar and craniofacial regions, armpits, and manifests itself in a symmetrical fashion in addition to being associated to family history. At present, sympathectomy is considered the golden standard treatment and there are a number of approaches a surgeon may elect to adopt in its care. The clinical treatment with oxybutynin also improves screening of the group of patients that will benefit the most with this indication. However, the efficacy of the surgical method, what most counts for a successful outcome is the occurrence or not of compensatory hyperhidrosis whose intensity may impact the results. All patients are and must be thoroughly informed of this possibility prior to surgery. For the others indications, is also one of the final approaches necessary for a fruitful treatment.

Does endoscopic thoracic sympathectomy improve the quality of life of patients with primary hyperhidrosis? A single center retrospective review

“…10 It is deemed the worst side effect of ETS, which impacts on daily activities. 11,12,13 However, only a few studies have assessed CS and if its intensity affects the QOL of patients, but the results were inconsistent. Dias et al 14 proposed that CS potentially worsens postoperative QOL.…”

Endoscopic Thoracic Sympathectomy for Digital Ischemia of the Right Hand: a Case Report of Improved Tissue Preservation and Pain Control

“…Endoscopic thoracic sympathectomy (ETS) is mainly recommended for primary hyperhidrosis. Less common indications include selected patients with Raynaud's syndrome, ischemic disease of upper limb extremities, complex regional pain syndrome and long QT syndrome refractory to clinical therapy [1,2]. We present a case of a patient, with incoercible pain due to digital ischemia of the right hand, who was treated with unilateral ETS that permitted optimal symptoms control and maximum tissue salvage.…”