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

Yıl 2019, Cilt: 3 Sayı: 5, 393 - 396, 28.05.2019

Hasan Oğuz Kapıcıbaşı

https://doi.org/10.28982/josam.518325

Cited By: 1

Öz

Aim: Video-assisted thoracoscopic sympathectomy (VATS) is a safe, minimally invasive and effective procedure for primer hyperhidrosis. In this research, we aimed to present the advantages of uniportal endoscopic thoracic sympathectomy (ETS) surgery on patients who had palmar and axillary hyperhidrosis and did not respond to medical treatment.

Methods: Between February 2012 and November 2018, 46 ETS surgeries were performed on 23 patients (12 female patients and 11 male patients; the average age was 21 [16-27]) and the outcomes were evaluated in this retrospective cohort study. Uniport (Richard Wolf) sympathicotripsy and Kuntz nerve ablation were performed. We presented all the data about surgical techniques, perioperative-postoperative complications and patient satisfaction with their long-term results.

Results: During the long term follow-ups of our patients, compensatory hyperhidrosis was the most frequently observed finding. Hyperhidrosis occurred in multiple areas of the body in 11 of the patients (47%). 22 patients were completely satisfied with ETS surgery, and one of our patient with compensatory back sweats reported partial satisfaction. Recurrent hyperhidrosis was observed on the left side of one of our patients at 33 months post-operative examination. Minimal pneumothorax was observed in one of the patients, and it was regressed with medical treatment. The average operation duration was recorded as 21 minutes (15-31) per each hemithorax. 

Conclusion: In conclusion, endoscopic thoracic sympathectomy is a treatment option with low mortality and morbidity. This approach should be considered for patients with palmar and axillar hyperhidrosis that medical treatment was not effective.

Anahtar Kelimeler

Hyperhidrosis, Quality of life, Uniportal thoracoscopic surgery, Sympathectomy

Palmar ve aksillar hiperhidrosis tedavisinde tek kesi ile bilateral endoskopik torakal sempatektomi

Öz

Amaç: Video yardımlı torakoskopik cerrahi primer hiperhidroz tedavisinde güvenli, minimal invaziv ve etkili bir işlemdir. Biz bu çalışmamızda, medikal tedaviden fayda görmeyen palmar ve aksiller hiperhidroz hastalarında endoskopik torasik sempatektomi (ETS) operasyonlarının avantajlarını sunmayı amaçladık.

Yöntemler: 2012 Şubat-2018 Kasım arasında yirmi üç hastaya (12 kadın,11 erkek yaş ortalaması 21 [16-27] kırk altı ETS operasyonu uygulandı ve sonuçlar bu retrospektif kohort çalışmada değerlendirildi. Uniport (Richard Wolf) T2-T4 sempatik ganglionu ve Kuntz sinir ablasyonu yapıldı. Cerrahi teknik ve operasyon süresi ile ilgili tüm veriler, perioperatif ve postoperatif komplikasyonlar, hasta memnuniyeti ve uzun dönem sonuçları sunuldu.

Bulgular: Hastalarımızın uzun dönem takiplerinde en sık olarak vücudun çeşitli bölgelerinde kompansatuar terleme gördük ve 11 (%47) oranındaydı. Yirmi iki hasta ETS operasyonundan tamamıyla memnundu. Kompansatuar sırt terlemesi olan bir hasta kısmen memnunluk bildirdi. Otuz üç ay sonra hastalarımızdan birinin sol tarafında tekrarlayan hiperhidrozis gözlendi. Bir hastamızda minimal pnömotoraks izlendi ve medikal tedaviyle geriledi. Ortalama operasyon süresi her bir hemitoraks için 21 dk (15-31) olarak kaydedildi. 

Sonuç: Medikal tedaviden fayda görmeyen hiperhidrozisli hasta grubunda, endoskopik torasik sempatektomi düşük mortalite ve morbidite ile yüksek hasta memnuniyeti sebebiyle tercih edilmesi gereken bir tedavi seçeneği olduğu sonucuna vardık.

Anahtar Kelimeler

Hiperhidroz, Yaşam kalitesi, Uniportal torakoskopi, Sempatektomi

Kaynakça

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