Article
Thorakale Sympathektomie bei der kindlichen Hyperhidrose
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Published: | November 20, 2009 |
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Background: Upper dorsal sympathectomy has been performed for a wide variety of indications, the most common of which is palmar hyperhidrosis. With the development of video-assisted thoracoscopic surgery, its application has extended to include thoracoscopic sympathectomy(excision of the the desired ganglion). In patients with palmar hyperhidrosis, thoracoscopic sympathectomy has been carried out with two or more skin incisions 10 mm each.
Purpose: To evaluate the use of minimally invasive technique using 5 mm ports and paediatric camera for dorsal sympathicotomy (electrocautery ablation of the desired ganglion) to minimize the surgical trauma and speed up the procedure in pediatric patients with palmar hyperhidrosis in Tanta University Hospital.
Patients and Methods: From April 2000 to August 2008, we performed 85 thoracoscopic sympathicotomies with mean age 16.3 years, ranged from 12 to 18 years. Fourteen procedures bilateral at the same session, sixty seven procedures staged bilateral two weeks apart and three procedures unilateral. Fulguration of T2-T3 in palmar hyperhidrosis.
Results: The mean operative time in this study were 16 minutes for each limb.There was no operative mortality. Dry warm hands were achieved in 83 out of 85 procedures. Technical failure 2/85due to massive pleural adhesions.There was 5 case of recurrence. Compensatory hyperhidrosis was improved in the follow-up period. However, it was found persistent in 8 procedures. The mean hospital stay were 1.3 days.
Conclusion: Video-assisted thoracoscopic sympathicotomy with two ports 5-mm each is a safe ,easy and effective way for controlling palmar hyperhidrosis with excellent results, minimal complications and short operative time.