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A single incision transaxillary thoracoscopic sympathectomy
Vojnosanitetski Pregled
|July 4, 2015
Summary
Video-assisted thoracoscopic sympathectomy effectively treats primary focal hyperhidrosis. This single-incision method offers excellent results and improved quality of life for most patients.
Area of Science:
- Thoracic surgery
- Surgical innovation
- Hyperhidrosis treatment
Background:
- Primary hyperhidrosis is a condition of unknown etiology, affecting both sexes and intensifying with puberty.
- Symptoms worsen with increased body temperature and emotional stimuli impacting the sympathetic nervous system.
- Current treatment options often lack long-term efficacy or have significant side effects.
Purpose of the Study:
- To evaluate the effectiveness of video-assisted thoracoscopic surgery (VATS) sympathectomy as a permanent treatment for primary focal hyperhidrosis.
- To demonstrate that a single-incision VATS sympathectomy maximizes effectiveness while minimizing aesthetic impact.
- To assess postoperative outcomes and patient quality of life following the procedure.
Main Methods:
- A prospective study analyzed patients undergoing single-incision transaxillary thoracoscopic sympathectomy (T2-T5) for primary focal hyperhidrosis (face, palms, armpits).
- The procedure involved a small incision in the third inter-rib space with two 5 mm flexible ports.
- Outcomes were assessed via clinical evaluation and visual analogue scale for morbidity and effectiveness.
Main Results:
- 94 bilateral VATS sympathectomies were performed on 47 patients (18 men, 29 women, average age 29).
- Complete symptom resolution occurred in 93.62% of patients, with 95.6% reporting improved quality of life.
- Low morbidity was observed, including 0% 30-day mortality and minimal complications (pneumothorax, transient Horner's syndrome).
- Excellent aesthetic results and no residual pain were noted post-surgery.
Conclusions:
- Single-incision transaxillary thoracoscopic sympathectomy is a safe and effective treatment for primary focal hyperhidrosis.
- The procedure yields excellent aesthetic and functional outcomes, significantly improving patients' quality of life.
- This minimally invasive approach offers a permanent solution for hyperhidrosis with minimal side effects.
