title: Thoracoscopic sympathectomy for palmar hyperhidrosis: effects on pulmonary function.
abstract: Palmar hyperhidrosis, probably caused by an over-reactivity of sympathetic nerves passing through the second and the third thoracic sympathetic ganglia (T2 & T3 ganglia), can only be cured by sympathectomy. Such sympathetic denervation may also alter pulmonary function. Previous studies have shown that open sympathectomy can cause significant deterioration in pulmonary function, however, the surgical procedure itself may contribute to the change. Recently thoracoscopic sympathectomy has been developed as a minimally invasive but effective treatment for palmar hyperhidrosis. In order to investigate the effect of sympathectomy, pulmonary function was compared before and four weeks after operation in 20 patients. Forced vital capacity (FVC) (-2.3%), forced expiratory volume in one second (FEV1) (-6.1%), and FEV1/FVC (-4.6%) were all slightly but significantly decreased four weeks after thoracoscopic sympathectomy. Also the instantaneous forced expiratory flow at 75%, 50% and 25% of the FVC (Vmax25, Vmax50, Vmax75) in flow-volume curves were decreased (-1.6%, -8.4%, and -20% respectively). Therefore, thoracoscopic sympathectomy minimises pulmonary restrictive effects but allows subclinical small airway obstructive effects to become more evident.
authors.affiliation: Division of Neurosurgery, Department of Surgery, Medical School and Hospital, National Taiwan University, 7 Chung-Shan South Road, Taipei, Taiwan, R.O.C. tmy59100@ms4.hinet.net
authors.forename: M Y
authors.initials: MY
authors.lastname: Tseng
authors.forename: J H
authors.initials: JH
authors.lastname: Tseng
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008168:Lung / Q000294:innervation / Q000502:physiology*; D008171:Lung Diseases / Q000209:etiology; D008297:Male; D008450:Maximal Midexpiratory Flow Rate; D012129:Respiratory Function Tests; D013562:Sympathectomy / Q000009:adverse effects* / Q000379:methods*; D013906:Thoracoscopy; D014797:Vital Capacity