Browse > Article

The Effect of Thoracoscopic Sympathicotomy at the 4th Rib (R4) for Treating Palmar Hyperhidrosis  

Noh, Dong-Sub (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, College of Medicine, Keimyung University)
Park, Chang-Kwon (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, College of Medicine, Keimyung University)
Kum, Dong-Yoon (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, College of Medicine, Keimyung University)
Kim, Jae-Bum (Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, College of Medicine, Keimyung University)
Publication Information
Journal of Chest Surgery / v.41, no.3, 2008 , pp. 343-346 More about this Journal
Abstract
Background: Thoracoscpic sympathicotomy is an effective treatment for essential hyperhidrosis. Patients are generally satisfied with the surgery at the early post operative period, but they suffer from recurrence and compensatory sweating at the late post operative period. There are many sympathicotomy methods for minimizing recurrence and the compensatory sweating. We compared the outcome from between the R3 and R4 sympathicotomy methods for the symptoms, atisfaction, recurrence and compensatory sweating. Material and Method: From January 1999 to July 2007, 39 cases of thoracoscopic sympathicotomy at the 3rd rib (R3) and 72 cases of thoracoscopic sympathicotomy at the 4th rib (R4) for treating palmar hyperhidrosis were compared for the early and late satisfaction, the compensatory sweating and recurrence. Result: There is no difference of gender and age for the 2 groups. Early satisfaction was reported by 94.9% of the R3 patients and by 98.7% of the R4 patients. 84.6% of the R3 patients reported late satisfaction and 87.5% of the R4 patients reported late satisfaction. There were no significant differences between the groups for the early and late satisfaction. But there was a difference between the groups for compensatory sweating (23.1% in the R3 group and 9.7% in the R4 group (p=0.020)). The reoperation rate due to recurrence was 5.1% in the R3 group and 4.2% in the R4 group. There was no significant difference between the groups for recurrence. Conclusion: R4 sympathicotomy has excellent therapeutic results for compensatory sweating as compared to R3 sympathicotomy for treating palmar hyperhidrosis.
Keywords
Hyperhidrosis; Sympathicotomy;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Shelly WB, Florence R. Compensatory hyperhidrosis of sympathectomy. N Engl J Med 1960;263:1056-8   DOI
2 Kao MC. Complications in patients with palmar hyperhidrosis treated with transthoracic endoscopic sympathectomy. J Neurosurg 1998;42:951-2   DOI
3 Lin CC, Telaranta T. Lin-Telaranta classification: the importance of different indications in sympathectic surgery. Ann Chir Gyn 2001;90:161-6
4 Neumayer C, Zcherl J, Holak G, et al. Limited endoscopic thoracic sympathetic block for hyperhidrosis of the upper limb: reduction of compensatory sweating by clipping T4. Surg Endosc 2004;18:152-6   DOI   ScienceOn
5 Chiou TSM, Liao KK. Orientation landmarks of endoscopic transaxillary T-2 sympathectomy for palmar hyperhidrosis. J Neurosurg 1996;85:310-5   DOI   ScienceOn
6 Gossot D, Galetta D, Pascal A, et al. Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Ann Thorac Surg 2003;75:1075-9   DOI   ScienceOn
7 Chung IH, Oh CS, Koh KS, Kim HJ. Anatomical variations of the T2 nerve root (including nerve of Kuntz) and their implications for sympathectomy. J Thorac Cardiovasc Surg 2002;123:498-501   DOI   ScienceOn
8 Lin TS, Fang HY. Transthoracic endoscopic sympathectomy in the treatment of palmar hyperhidrosis-with emphasis on perioperative management (1,360 case analysis). Surg Neurol 1995;52:453-7
9 Adar R. Compensatory hyperhidrosis after thoracic sympathectomy. Lancet 1998;351:231-2   DOI   ScienceOn
10 Doolabh N, Horswell S, Williams M, et al. Thoracic sympathectomy for hyperhidrosis:indications and results. Ann Thorac Surg 2004;77:410-4   DOI   ScienceOn
11 Kux E. Thoracic endoscopic sympathicotomy in palmar & axillary hyperhidrosis. Ach Surg 1978;113:264-6
12 Lin TS. Video-assited thoracoscopic "Resympathicotomy" for palmar hyperhidrosis: analysis of 42 cases. Ann Thorac Surg 2001;72:895-8   DOI   PUBMED   ScienceOn