Results, side effects and complications after thoracoscopic sympathetic block by clamping. The monza clinical experience.
BACKGROUND
Video-endoscopic sympathectomy is the current treatment of choice for severe primary hyperhidrosis. Because of the possible postsurgical side effects, the procedure is carried out using removable endoclips that block sympathetic nerve transmission. This study describes the short and "midterm" side effects and complications of this method for the treatment of palmar, axillary, and facial hyperhidrosis.


METHODS
Two hundred and ninety-four sympathectomies were carried out between September 2003 and June 2006 and followed-up after 17 months. Patients with isolated facial hyperhidrosis were clamped at the T2-3 level clamping. Patients with isolated axillary hyperhidrosis were clamped at the T3-4 level.


RESULTS
All patients with palmar and palmar-axillary hyperhidrosis were completely satisfied after clamping at the third thoracic ganglion (T3) level. Immediate complete recovery was achieved in 98% of patients postsurgery. Major complications were Horner's syndrome (1%) and pneumothorax (3%). Compensatory sweating occurred in 22%. No cases of gustatory sweating were reported. All patients were "satisfied" with their results and no patients requested removal of the clips.


CONCLUSIONS
Thoracoscopic sympathecotomy clamping is a successful treatment for hyperhidrosis. Local hyperhydrosis does not reoccur after 17 months, but there is some degree of compensatory hyperhidrosis.
Sciuchetti
Jennifer Francesca
JF
Division of Thoracic Surgery, Department of Thoracic and Cardiovascular Surgery, Universitary San Gerardo Hospital, Milan, Italy. jlorenz@libero.it
Corti
Fabrizio
F
Ballabio
Dario
D
Angeli
Marcello Costa
MC
D000293:Adolescent; D000328:Adult; D001340:Autonomic Nerve Block; D003250:Constriction; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000150:complications* / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013562:Sympathectomy / Q000009:adverse effects; D016896:Treatment Outcome