Nesimi GÜNAL, Berkant ÖZPOLAT, Yasemin Dere GÜNAL, Koray DURAL

Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

Hyperhidrosis is defined as excessive sweating beyond the physiologic needs of a person. Palmar hyperhidrosis in the adolescent period may have an impact on school work and may cause psychological problems. In this study we aim to increase awareness of this disregarded problem. Materials and methods: We explicated the early outcomes of 7 consecutive adolescents, where single port video-assisted thoracoscopic sympathectomy was performed for primary palmar hyperhidrosis. Patients were evaluated for symptom resolution, which was defined as complete dryness, patient satisfaction, operative complications, and compensatory sweating. Results: In total 13 thoracoscopic procedures were done in 7 adolescents, consisting of 4 girls and 3 boys (median age = 16 years). Thoracoscopic sympathectomy achieved immediate complete dryness and all were very satisfied with the outcome of the procedure. Compensatory sweating was defined as mild by 4 (57%) patients. Conclusion: Thoracoscopic sympathectomy is safe and effective for the treatment of primary palmar hyperhidrosis in the adolescent period without any major side effects.

Anahtar Kelimeler:

Key words: Hyperhidrosis, video-assisted thoracoscopic surgery, sympathectomy

Single port thoracoscopic sympathectomy for primary palmar hyperhidrosis in adolescence

Keywords:

Key words: Hyperhidrosis, video-assisted thoracoscopic surgery, sympathectomy,

PDF

___

1. Bellet JS. Diagnosis and treatment of primary focal hyperhidrosis in children and adolescents. Semin Cutan Med Surg 2010; 29: 121–126.
2. Kravarusic D, Freud E. Thoracoscopic sympathectomy ganglia ablation in the management of palmer hyperhidrosis: a decade experience in a single institution. Afr J Paediatr Surg 2012; 9: 143–147.
3. Steiner Z, Cohen Z, Kleiner O, Matar I, Mogilner J. Do children tolerate thoracoscopic sympathectomy better than adults? Pediatr Surg Int 2008; 24: 343–347.
4. Law NW, Ellis H. Transthoracic sympathectomy for palmar hyperhidrosis in children under 16 years of age. Ann R Coll Surg Engl 1989; 71: 70–71.
5. Gelbard CM, Epstein H, Hebert A. Primary pediatric hyperhidrosis: a review of current treatment options. Pediatr Dermatol 2008; 25: 591–598.
6. Steiner Z, Kleiner O, Hershkovitz Y, Mogilner J, Cohen Z. Compensatory sweating after thoracoscopic sympathectomy: an acceptable trade-off. J Pediatr Surg 2007; 42: 1238–1242.
7. Cohen Z, Levi I, Pinsk I, Mares AJ. Thoracoscopic upper thoracic sympathectomy for primary palmar hyperhidrosis—the combined paediatric, adolescents and adult experience. Eur J Surg 1998; 580: 5–8.
8. Hornberger J, Grimes K, Naumann M, Glaser DA, Lowe NJ, Naver H, Ahn S, Stolman LP. Recognition, diagnosis, and treatment of primary focal hyperhidrosis. J Am Acad Dermatol 2004; 51: 274–286.
9. Sazak H, Göktaş U, Alagöz A, Sevgen Demirbaş Ç, Güven Ö, Şavkılıoğlu E. Comparison of two different right-sided doublelumen tubes with different designs. Turk J Med Sci 2012; 42: 1063–1069.
10. Kalkan MT, Aydemir EH, Karakoç Y, Körpınar MA. The measurement of sweat intensity using a new technique. Turk J Med Sci 1998; 28: 151–517.
11. Kux M. Thoracic endoscopic sympathectomy in palmar and axillary hyperhidrosis. Arch Surg 1978; 113: 264–266.
12. Licht PB, Pilegaard HK. Severity of compensatory sweating after thoracoscopic sympathectomy. Ann Thorac Surg 2004; 78: 427–431.
13. Atkinson JL, Fode-Thomas NC, Fealey RD, Eisenach JH, Goerss SJ. Endoscopic transthoracic limited sympathotomy for palmar-plantar hyperhidrosis: outcomes and complications during a 10-year period. Mayo Clin Proc 2011; 86: 721–729 . 14. Li X, Tu YR, Lin M, Lai FC, Chen JF, Dai ZJ. Endoscopic thoracic sympathectomy for palmar hyperhidrosis: a randomized control trial comparing T3 and T2-4 ablation. Ann Thorac Surg 2008; 85: 1747–1751.
15. Deng B, Tan QY, Jiang YG, Zhao YP, Zhou JH, Ma Z, Wang RW. Optimization of sympathectomy to treat palmar hyperhidrosis: the systematic review and meta-analysis of studies published during the past decade. Surg Endosc 2011; 25: 1893–1901.
16. Ng CSH, Yeung EC, Wong RH, Kwok MW. Single-port sympathectomy for palmar hyperhidrosis with Vasoview Hemopro 2 endoscopic vein harvesting device. J Thorac Cardiovasc Surg 2012; 144: 1256–1257.
17. Apiliogullari B, Esme H, Yoldas B, Duran M, Duzgun N, Calik M. Early and midterm results of single-port video-assisted thoracoscopic sympathectomy. Thorac Cardiovasc Surg 2012; 60: 285–289.
18. Akın Takmaz S, Yarkan Uysal H, İnan N, Kaptan Z, Başar H. Effects of right and left stellate ganglion block on blood pressure and QT-QTc intervals in patients with primary Raynaud’s phenomenon. Turk J Med Sci 2012; 42: 89–94.
19. Ergin M, Yeginsu A, Gürlek İK. The effects of local anaesthesia with bupivacaine and botulinum toxin-A after thoracotomy on stress hormone levels. Turk J Med Sci 2011; 41: 877–882.
20. Asabe K, Oka Y, Kai H, Shirakusa T, Iwasaki A. Thoracoscopic surgery in children in the Kyushu area of Japan. Pediatr Int 2009; 51: 250–253.
21. Zacherl J, Huber ER, Imhof M, Plas EG, Herbst F, Függer R. Long-term results of 630 thoracoscopic sympathicotomies for primary hyperhidrosis: the Vienna experience. Eur J Surg 1998; 164: 43–46.