Different outcomes between two sides after bilateral sympathetic ganglion interruption for hyperhidrosis.
BACKGROUND
Although the determination of the correct ganglion under direct vision through thoracoscopy by an experienced surgeon is almost unerring, there is still a 4.3% rate of clipping at the unintended level.


METHODS
Through the review of the most recent patients (N = 117) with various sympathetic disorders undergoing thoracoscopic sympathetic interruption over different ganglions by clipping, we found that 5 cases were clipped at the unplanned level. The immediate manifestations were the different outcomes between both sides of the face, trunk, and extremities. The postoperative chest radiographs demonstrated the error.


RESULTS
All patients received a second operation in which the unintended clip was removed, and a new one was applied to the appropriate ganglion. The results were satisfactory.


CONCLUSIONS
Although the authors in this study have the experience of more than 1000 cases of hyperhidrosis, such an error is still inevitable. Luckily, by using the clipping method, the error is detectable and amendable.
Chou
Shah-Hwa
SH
Department of Surgery, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
Kao
Eing-Long
EL
Lin
Chien-Chih
CC
Huang
Meei-Feng
MF
D003714:Denervation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D005728:Ganglia, Sympathetic / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006945:Hyperhidrosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D012086:Reoperation / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data; D035423:Thoracic Cavity / Q000033:anatomy & histology / Q000601:surgery; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome