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Bilateral sympathicotomy for hyperhidrosis without using single-lung ventilation.

Tevfik Kaplan, Perihan Ekmekçi, Bülent Koçer

    Turkish Journal of Medical Sciences
    |October 2, 2015
    PubMed
    Summary

    Bilateral videothoracoscopic sympathicotomy without lung isolation effectively treats hyperhidrosis and facial blushing. This minimally invasive approach offers a shorter operative time and good long-term results with manageable complications like compensatory sweating.

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    Area of Science:

    • Thoracic surgery
    • Minimally invasive procedures
    • Surgical treatment of hyperhidrosis

    Background:

    • Primary hyperhidrosis and facial blushing significantly impact quality of life.
    • Traditional treatments for hyperhidrosis may have limitations.
    • Videothoracoscopic sympathicotomy offers a less invasive surgical option.

    Purpose of the Study:

    • To evaluate the outcomes and complications of bilateral videothoracoscopic sympathicotomy.
    • To assess the efficacy of this procedure without single-lung ventilation.
    • To determine the safety and effectiveness for treating primary hyperhidrosis and facial blushing.

    Main Methods:

    • Retrospective review of 154 patients undergoing bilateral sympathicotomy for hyperhidrosis or facial blushing.

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  • Procedure performed via videothoracoscopy using a single-lumen endotracheal tube during controlled apnea.
  • Sympathicotomies targeted at costal levels 2, 3, and 4.

    • Main Results:

    • No perioperative mortality or need for conversion to open surgery.
    • Mean operation time was 31.2 minutes; mean hospital stay was 1.1 days.
    • 18.8% experienced compensatory sweating; no recurrence observed during a mean follow-up of 21.4 months.

    Conclusions:

    • Bilateral videothoracoscopic sympathicotomy without lung isolation is an effective treatment for primary hyperhidrosis and facial blushing.
    • The procedure is associated with shorter operative times and no significant hemodynamic changes.
    • This technique provides a safe and effective surgical solution with manageable long-term outcomes.