Asystole following bilateral endoscopic thoracic sympathectomy

Background Endoscopic thoracic sympathectomy (ETS) is an effective treatment for primary hyperhidrosis. However, compensatory sweating (CS) may occur in many patients. Sympathetic nerve reconstruction (SNR) can be used to counteract severe CS, but the studies on the effects of SNR are few. Patients and Methods Nineteen out of 150 SNR patients were contacted by employing a long-term questionnaire. In this questionnaire, different kinds of sweating were evaluated using a four-graded symptom analysis and the visual analog scale before ETS, after ETS, and after SNR. Results The mean age of the 16 male and 3 female patients at the SNR was 32 years. The mean follow-up was 87 months. According to the long-term questionnaire, the benefit was either excellent (4 patients, 21%), good (3 patients, 15.8%), or reasonable (7 patients, 36.8%) in 14 patients (73.8%), while the benefit was questionable in 1 patient (5.3%). For three patients (15.8%), no benefit was found, and in one patient (5.3%), the situation had deteriorated. Conclusions Improvement in the side effects of ETS after SNR was found in nearly 75% of the patients. This indicates that SNR can be considered as an alternative treatment for patients with severe CS after ETS that is unresponsive to conservative treatment.

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Risk reduction of long-term major adverse cardiovascular events after endoscopic thoracic sympathectomy in palmar hyperhidrosis

Clinical Autonomic Research ◽

10.1007/s10286-017-0464-0 ◽

2017 ◽

Vol 27 (6) ◽

pp. 393-400 ◽

Cited By ~ 4

Author(s):

Chun-An Cheng ◽

Chun-Gu Cheng ◽

Hsin Chu ◽

Hung-Che Lin ◽

Chi-Hsiang Chung ◽

...

Keyword(s):

Risk Reduction ◽

Cardiovascular Events ◽

Palmar Hyperhidrosis ◽

Major Adverse Cardiovascular Events ◽

Endoscopic Thoracic Sympathectomy ◽

Thoracic Sympathectomy

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Endoscopic Thoracic Sympathectomy

European Journal of Vascular and Endovascular Surgery ◽

10.1053/ejvs.2002.1638 ◽

2002 ◽

Vol 23 (6) ◽

pp. 570

Author(s):

A. Cameron

Keyword(s):

Endoscopic Thoracic Sympathectomy ◽

Thoracic Sympathectomy

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Endoscopic Thoracic Sympathectomy : A Comparative Study of Resection and Electro-Diathermy Ablation in the Treatment of Primary Palmar Hyperhidrosis : Taif Experience

The Egyptian Journal of Hospital Medicine ◽

10.12816/0000601 ◽

2013 ◽

pp. 637-641

Author(s):

Mohamed Al Saeed ◽

Majed Al Mourgi ◽

Mohamed Hatem

Keyword(s):

Comparative Study ◽

Palmar Hyperhidrosis ◽

Endoscopic Thoracic Sympathectomy ◽

Thoracic Sympathectomy

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A retrospective review on minimally invasive technique via endoscopic thoracic sympathectomy (ETS) in the treatment of severe primary hyperhidrosis: Experiences from the National Heart Institute, Malaysia

F1000Research ◽

10.12688/f1000research.14777.1 ◽

2018 ◽

Vol 7 ◽

pp. 670

Author(s):

Ahmad Farouk Musa ◽

Vignaa Prashanth Gandhi ◽

Jeswant Dillon ◽

Rusli Bin Nordin

Keyword(s):

Sweat Glands ◽

Invasive Technique ◽

Moderate Degree ◽

Endoscopic Thoracic Sympathectomy ◽

Thoracic Sympathectomy ◽

Primary Hyperhidrosis ◽

Response To Stress ◽

Pertinent Information

Background: Hyperhidrosis is due to the hyperactive autonomic stimulation of the sweat glands in response to stress. Primary hyperhidrosis is a common yet psychologically disabling condition. This study will describe our experience in managing hyperhidrosis via endoscopic thoracic sympathectomy (ETS). Methods: The information was obtained from the patient records from 1st January 2011 until 31st December 2016. Pertinent information was extracted and keyed into a study proforma. Results: 150 patients were operated on but only 118 patients were included in this study. The mean age was 22.9±7.3 years. The majority (54.2%) had palmar-plantar hyperhidrosis and 39.8% had associated axillary hyperhidrosis. Excision of the sympathetic nerve chain and ganglia were the main surgical technique with the majority (55.9%) at T2-T3 level. Mean ETS procedure time was 46.6±14.29 minutes with no conversion. Surgical complications were minimal and no Horner’s Syndrome reported. Mean hospital stay was 3.5±1.05 days. The majority of patients (67.8%) had only one follow-up and only half of the study sample (58.5%) complained mild to moderate degree of compensatory sweating, even though the long-term resolution is yet to be determined by another study. Following ETS, 98.3% of patients had instant relief and resolved their palmar hyperhidrosis. Predictors of CS were sympathectomy level and follow-up. The odds of reporting CS was 2.87 times in patients undergoing ETS at the T2-T3 level compared to those undergoing ETS at the T2-T4 level. The odds of reporting CS was 13.56 times in patients having more than one follow-up compared to those having only one follow-up. Conclusion: We conclude that ETS is a safe, effective and aesthetically remarkable procedure for the treatment of primary hyperhidrosis with only half of the patients developing mild to moderate degree of CS. Significant predictors of CS were sympathectomy level during ETS and frequency of follow-up after ETS.

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