Thorascopic sympathectomy performed using laser.

Abstract

INTRODUCTION:

Thorascopic sympathectomy is accepted as an effective treatment for palmar hyperhidrosis, facial blushing and to a lesser extent for digital ischaemia and axillary hyperhidrosis.

PATIENTS AND METHODS:

Data were collected retrospectively on patients undergoing thorascopic sympathectomy at St Peter's Hospital between 1987 and 2006. Patients were followed up by telephone interview.

RESULTS:

A total of 233 thorascopic sympathectomy procedures were performed by a single operator in 123 patients. Ages ranged from 9-71 years and 75 were women. In patients, 105 had a bilateral and 13 a unilateral procedure, 5 patients had a bilateral procedure performed in two stages. In 6 upper limbs, the procedure could not be done. Overall, 110 patients (90%) had the procedure performed for palmar hyperhidrosis, 8 (6%) for facial blushing and in 5 (4%) patients the operation was performed for digital ischaemia with tissue loss. There were no deaths and all patients were discharged on day 1 following the procedure. Complications included bleeding (2), pulmonary oedema (1) and failed procedure (2); however, no incidences of Horner's syndrome occurred. Only 40 of 123 (32.5%) patients gave follow-up information. Of this small group, 33 of 40 (83%) were cured, 4 of 40 (10%) were better, 2 of 40 (5%) were unchanged and 1 patient was worse. Only 22 out of 40 (55%) of these patients were troubled by compensatory sweating, with only 4 of 40 (10%) reporting this as a major problem.

CONCLUSIONS:

Thorascopic sympathectomy is safe and can be carried out as a single bilateral procedure in the majority of cases. The laser allows the use of a single port, requires less dissection than surgical or clipping techniques, is more precise than diathermy and may be less likely to cause a Horner's syndrome.

• Authors: S A Black, F G M Taylor, M H Russell, R Ariga, M H Thomas
• Journal: Annals of the Royal College of Surgeons of England (Ann R Coll Surg Engl) Vol. 90 Issue 2 Pg. 142-5 (Mar 2008) ISSN: 1478-7083 [Electronic] England
• PMID: 18325216 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Blushing
• Child
• England
• Female
• Fingers (blood supply)
• Flushing (surgery)
• Humans
• Hyperhidrosis (surgery)
• Ischemia (surgery)
• Laser Therapy (methods)
• Male
• Middle Aged
• Retrospective Studies
• Sympathectomy (instrumentation, methods)
• Thoracoscopy
• Toes (blood supply)
• Treatment Outcome