Korean J Thorac Cardiovasc Surg.  1998 May;31(5):525-530.

Cosmetic Thoracic Sympathectomy for Palmar Hyperhidrosis using 2 mm Thoracoscopic Instruments

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.
  • 2Seoul National University College of Medicine, Seoul, Korea.

Abstract

Thoracoscopic thoracic sympathectomy for primary palmar hyperhidrosis has been known to be effective and to have cosmetic merits compared to conventional open sympathectomy. In spite of its cosmetic advantages over thoracotomy, VATS using 5 mm or 10 mm instruments still has the problem of operative wound as well as pain on trocar sites. Recently, 2 mm thoracoscopic instruments have been used. The purpose of this study was to examine the results of thoracoscopic sympathectomy for palmar hyperhidrosis with 2 mm thoracoscopic instruments. From January 1997 to April 1997, 46 patients underwent bilateral thoracoscopic sympathectomy with 2mm instruments at Seoul National University Hospital. T-2 ganglion was carefully dissected and resected out in all patients. In one patient, the lower third of T-1 ganglion was inadvertently resected together with T-2 ganglion due to poor anatomical localization. In 4 patients who also complained of excessive axillary sweating, T-3 ganglion was resected as well. The instruments were removed without leaving any chest drain after reexpansion of the lung. Trocar sites were approximated with sterile tapes. All patients were relieved of excessive sweating in their upper extremities immediately after the operation. Nine patients (19.6%) showed incomplete reexpansion of the lung, and two of them required needle aspiration. Complications related to the surgical procedures, such as Horner's syndrome, hemothorax, and brachial plexus injury, were not detected in any cases. Most patientsdid not complaine of pain. All patients were discharged from the hospital on the day of operation. Despite a narrow operative viewfield, thoracic sympathectomy with 2 mm thoracoscopic instruments can be performed without increasing any severe complications. We recommend 2 mm instruments for thoracoscopic sympathectomy because they make as the more cosmetic, less painful, and equally effective compared to thoracoscopic sympathectomy using 5 mm or greater instruments.

Keyword

hyperhidrosis; thoracoscopy

MeSH Terms

Brachial Plexus
Ganglion Cysts
Hemothorax
Horner Syndrome
Humans
Hyperhidrosis*
Lung
Needles
Seoul
Surgical Instruments
Sweat
Sweating
Sympathectomy*
Thoracic Surgery, Video-Assisted
Thoracoscopy
Thoracotomy
Thorax
Upper Extremity
Wounds and Injuries
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