• Journal of Chest Surgery
• /
• v.29 no.10
• /
• pp.1129-1132
• /
• 1996

Excessive sweating of the face has a strong negative impact on the quality of life for many persons. We have experienced 10 patients with facial hyperhidrosis among the 150 essential hyperhidrosis patients They were 9 male and 1 fatale patients and their age range was 20 to 47 years(mean age 33.8 years). All patients, except one, received bilateral thoracic sympathectomy via VATS. One patient was done via minithoracotomy due to severe pleural adhesion. During the followup period, there was no recurence of facial sweating. Hone of the patients showed Horne 's syndrome.

• Journal of Chest Surgery
• /
• v.31 no.7
• /
• pp.703-710
• /
• 1998

We treated 654 patients with simultaneous bilateral sympathectomy for essential hyperhidrosis from March 1989 to September 1997(354 males and 300 females). The exposure afforded by thoracoscopy is actually superior to that seen at the time of either thoracotomy or axillary thoracotomy. The use of single-lumen intubation with alternating partially collapsed lung by CO2 inflation resulted in shorter anesthesia, shorter operative time, and shorter hospitalization. 2-mm extended thoracoscopic T2-sympathectomy is not only a time-saving method but also a very simple and effective one in the treatment of hyperhidrosis by experienced surgeons. The modification on our technique of thoracoscopic sympathectomy as described allowed us to significantly improve our previous results. A majority of the patients were relieved, and over 95% were satisfied initially.

• Journal of Chest Surgery
• /
• v.31 no.7
• /
• pp.697-702
• /
• 1998

Hyperhidrosis of the palms, axillae, and the face has a strong negative impact on the quality of life for many people. Existing nonsurgical therapeutic options are far from ideal. A definitive cure can be obtained by upper thoracic sympathectomy. The traditional open surgical technique is a major procedure; few patients and doctors have found that risk-benefit considerations favor surgery. Endoscopic minimal invasive surgical techniques are now available. We investigated whether endoscopic ablation of upper thoracic sympathetic chain(T2-4) is an efficient and safe treatment of hyperhidrosis. We treated 40 patients with bilateral endoscopic transthoracic sympathectomy. There were no mortalities, life-threatening complication, no treatment failures occurred in 40 patients. After a short-term follow-up, 100% of the patients reported satisfactory results. Endoscopic transthoracic sympathectomy is an efficient, safe, and minimally invasive surgical method for the treatment of palmar, axillary hyperhidrosis.

• Journal of Chest Surgery
• /
• v.30 no.11
• /
• pp.1105-1110
• /
• 1997

Essential hyperhidrosis is a condition with excessive sweating, which may be localized in any part of the body Excessive sweating has a strong negative impact on the qual ty of life for many persons. From June 1992 to May 1996, 211 cases of thoracoscopic thoracic sympathectomy were performed in the Department of Thoracic Surgery, Yongdong Severance Hospital, Seoul, Korea. Among the 211 cases, 192 patients had palmar hyperhidrosis, and 19 cases had facial hyperhidrosis. There were 121 males and 90 (tamales, and the ages ranged from 10 to 67 years(average: 24.82 years old). The average operation time and the average postoperative hospital stay were 91.94 minutes and 4.31 days, respectively. Perioperative courses were uneventful, and all the patients had immediate and complete relief of symptoms with mild compensatory sweating on the chest wall and the back. Even though a thoracoscopy has the possibility of emergency conversion to a thoracotomy and technical difficulties still exist, especially in patients with facial hyperhidrosis, our experience indicates that video-assisted thoracoscopic thoracic sympathectomy is a very safe and useful procedure for h perhidrosis.

• Journal of Chest Surgery
• /
• v.31 no.4
• /
• pp.388-392
• /
• 1998

Hyperhidrosis is one of abnormalities in autonomic nervous system, it has been treated with dermatologic principles or thoracic sympathectomy via thoracotomy. But these techniques were rather ineffective or invasive. Recently, Video Assisted Thoracoscopic Surgery(VATS) is widely applided in thoracic surgical area, and palmar & axillary hyperhidrosis is not the exception. From August 1995 to February 1997, 52 patients with bilateral palmar hyperhidrosis underwent bilateral thoracic sympathectomy with VATS in the department of thoracic & cardiovascular surgery, Inje university, Pusan Paik Hospital. There were 27 men and 25 women and the mean age was 22 years. Mean operating time was 172 min and unilateral sympathectomy via minithoracotomy was applied in one patient due to severe pleural adhesion. Mean postoperative hospital stay was 2.6 days. During mean 12.5 months follow-up, there was no recurrence of sweating in the both hands. Thirty patients(57.7%) complained moderate degree of compensatory sweating, but the discomfort was decreased in severity. 83.8% of all patients were satisfied with the result of operation.

• Journal of Chest Surgery
• /
• v.36 no.8
• /
• pp.595-601
• /
• 2003

Background: It has been known that the most effective treatment method of hyperhidrosis is video-assisted thoracoscopic sympathetic nerve block. Postoperative compensatory hyperhidrosis and anhidrosis are major factors that decrease the postoperative satisfaction. Although sympathetic rami have been selectively blocked to decrease the complications, technical difficulties and excessive bleeding have prevented the universal application. Material and Method: Three pre-fixative cadavers were dissected before clinical application. Bilateral sympathetic chains were exposed in supine position after the whole anterior chest wall was removed. Second and third sympathetic rami were blocked using clips. After the sympathetic chains including ganglia were removed, we evaluated the extents of rami block. Twenty-five patients were subjected to the clinical application. Surgeries were performed in semi-fowlers position under general anesthesia and bilateral ventilation. 2 mm thoracoscopy and 5 mm trocar were intro-duced through third and fourth intercostal space, respectively. Second and third sympathetic rami were blocked using thoracoscopic clips. The postoperative complications, satisfaction, and compensatory hyperhidrosis rate were evaluated retrospectively. Result: Sympathetic rami were completely blocked in cadaver dissection study Hyper-hidrosis symptom was improved in all patients without operative complication. Operative time was shorter than that of traditional ramicotomy. All patients, except four, were satisfied with postoperative palmar hyperhidrosis. Com-pensatory hyperhidrosis was more severely happened in fifteen patients (60%). The remaining six patients had no complaint. Two patients had a minimal degree of gustatory hyperhidrosis. Conclusion: This operative method had shorter operative time and less complication rate, compared with traditional ramicotomy Operative success rate was similar to the traditional syrnpathicotorny; lower extent and occurrence rate of compensatory hyperhidrosis. The thoracic sympathetic rami clipping was suggested as an alternative method for treatment of palmar hyperhidrosis.

• Journal of Chest Surgery
• /
• v.31 no.11
• /
• pp.1089-1093
• /
• 1998

Background: In 1992, we first developed the technique for video-assisted thoracoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Clinically, patients suffereing from distressing hyperhidrosis in their heads and faces were observed. Materials and methods: From March 1997 to March 1998, the vidio-assisted thoracoscopic sympathectomy and sympathicotomy were performed in 60 patients suffering from craniofacial hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Thirty-nine patients underwent a conventional sympathectomy(T1 sympathectomy group), and twenty-one patients underwent division of the sympathetic nerve trunk above the T2 sympathetic ganglion(T2 sympathicotomy). The median follow up was 9 months. Results: All of the treated patients obtained satisfactory alleviation of craniofacial hyperhidrosis. No recurrence was observed in group T1 sympathectomy whereas one occurred in sympathicotomy. The global rate of compensatory sweating was about the same in both groups ; 76.9% in T1 sympathectomy and 76.2% in T2 sympathicotomy. The rate of embarrassing and disabling compensatory sweating was 38.5% in T1 sympathectomy and 38.1% in T2 sympathicotomy with no significant in the statistic analysis(p> 0.05). No transient Horner's syndrome was observed in group T2 sympathicotomy whereas seven occurred in T1 sympathectomy with improvement in follow-up. Only an overnight hospital stay was required in both group. Conclusions: The video-assist thoracoscopic sympathicotomy is minimally invasive and effective. Video-assisted thoracoscopic T2 sympathicotomy has proven to be effective method and less complicated in treating patients with distressing craniofacial hyperhidrosis and consistent in obtaining the same results as T1 sympathectomy.

• Journal of Chest Surgery
• /
• v.31 no.12
• /
• pp.1212-1216
• /
• 1998

Background: Recently thoracoscopic surgery is widely applied in thoracic surgical field and hyperhidrosis is one of the most frequently operated diseases. Material and Method: From June 1997 to February 1998, 30 patients with hyperhidrosis underwent bilateral thoracic sympathectomy under thoracoscopy at Inje University Sanggye Paik Hospital. There were 10 males and 20 females whose mean age was 22.42±6.84 years ranging from 17 to 51. All patients underwent bilateral thoracic sympathectomy under semi-sitting position and two 5 mm sized trocars were inserted. Result: Mean operation time was 52.32±11.72 minutes and the mean elevation of palmar temperature after sympathectomy was 2.17±0.47℃. Eighteen patients(60%) complained compensatory hyperhidrosis. All patients except one were able to discharge at the operation day or postoperative one day. There were no recurrence during follow up from 2 to 8 months(mean 5.30±2.17 months). Conclusion: Thoracoscopic sympathectomy is simple and effective technique in hyperhidrosis and widely applied indication will be necessary. We conclude that further discussion should be made about the resection area and method to get maximal effect and minimal side effect.

• Journal of Chest Surgery
• /
• v.31 no.2
• /
• pp.203-207
• /
• 1998

We have experienced 2 patients who underwent retroperitoneal endoscopic lumbar sympathectomy(RELS) for bilateral plantar hyperhidrosis. They had underwent thoracic sympathectomy by thoracoscopy 20 months and 1 month ago, respectively. The first patient had to be converted to the open procedure due to pneumoperitonium and she was reoperated due to continous sweating by the incomplete sympathectomy on right side. At follow-up after 70 and 30 days postoperatively, RELS results were graded as excellent, good, fair, or poor. The first patient was very satisfied as "Excellent" and the second was slightly less satisfied as "Good" with compensatory hyperhidrosis at perianal area. This RELS is a feasible procedure to plantar hyperhydrosis patients with less pain, minimal scar, short period of convalescence, and short hospital stay.short hospital stay.

• The Journal of Internal Korean Medicine
• /
• v.42 no.5
• /
• pp.1001-1008
• /
• 2021

Objective: The aim of this case study was to describe a case of iris diagnosis of primary hyperhidrosis and the use of Korean medicine. Methods: A patient with symptoms of hyperhidrosis was diagnosed as having Taeeumin after assessment using the four basic Korean diagnostic methods. Iris diagnosis was used for further examination. The images obtained showed a remarkably defined collarette and increased nerve rings, which suggested an overactive sympathetic nerve system. Under the diagnosis of Taeeum, a Korean herbal medicine was prescribed with additional herbs to help alleviate the hyperactivity of the sympathetic nervous system. Results: The patient had been receiving treatment for hyperhidrosis for >30 years, with various medical attempts to relieve her symptoms, which were ineffective. She showed signs of improvement from day 4 into the treatment, and 80% of her symptoms were improved after completing a 6-week treatment course. Conclusion: The herbal medicine prescribed to the patient proved effective for reducing her chronic symptoms that had been unresponsive to previous medical treatments.