title: [Initial experience of a program of clipping the sympathetic nervous system for the treatment of hyperhidrosis and facial flush].
abstract: OBJECTIVE
  To evaluate the results of our program of clipping the thoracic sympathetic nervous system (TSNS) for the treatment of facial flush and/or hyperhidrosis (HH), and to compare the methodology-results of the program development phase (A: January 2007-April 2009) and its consolidation phase (B: May 2009-March 2010).
  
  
  METHODS
  The program included a total of 44 patients (88 procedures) subjected to videothoracoscopy and clipping of the TSNS in a one day surgery unit. Data were collected and analysed retrospectively, and a descriptive and comparative statistical analysis was performed between the two periods (A and B).
  
  
  RESULTS
  The overall morbidity was 5 cases (11.3%). The post-surgical occurrence rate of HH was 4.54% (2 cases), and the incidence of compensatory sweating was 65.9% (minimal in 26 of the 29 cases). On comparing period B with period A, there was a significant decrease in surgical time, disappearance of recurrence of HH, a decrease of 30% in morbidity, reduction by half in the incidence of moderate to severe compensatory sweating, and an increase in the level of satisfaction. The clamps were removed in one of the poorly tolerated compensatory sweating cases, resulting in its disappearance.
  
  
  CONCLUSIONS
  Clipping the TSNS is a safe technique in the one day surgery unit, with a short learning curve (20 cases) after which comparable, or even better, results are obtained than those of sympatholysis. These results, together with their potential reversibility, makes it, in our opinion, the technique of choice in the surgery of the TSNS.
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España. cmartinezb.germanstrias@gencat.cat
authors.forename: Carlos
authors.initials: C
authors.lastname: Martinez-Barenys
authors.forename: Javier
authors.initials: J
authors.lastname: Pérez
authors.forename: Pedro
authors.initials: P
authors.lastname: López De Castro
authors.forename: Alicia
authors.initials: A
authors.lastname: Melero
authors.forename: Miguel
authors.initials: M
authors.lastname: Mesa
authors.forename: Samuel
authors.initials: S
authors.lastname: García
authors.forename: Esther
authors.initials: E
authors.lastname: Fernández
authors.forename: Julio
authors.initials: J
authors.lastname: Astudillo
mesh_terms: D000328:Adult; D005260:Female; D005483:Flushing / Q000601:surgery*; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D013562:Sympathectomy / Q000379:methods*