title: Single-port thoracoscopic sympathicotomy using a double-lumen electrocautery tube and cautery hook for primary palmar hyperhidrosis: a randomized controlled trial.
abstract: OBJECTIVE
  The objective of this study is to assess the use of a novel, double-lumen electrocautery tube (DLET) device for ablating the sympathetic nerve chain in patients with primary palmar hyperhidrosis (PPH).
  
  
  METHODS
  Forty-six patients with severe PPH were recruited into the study between November 2010 and February 2012. All patients underwent single port, bilateral video-assisted thoracoscopic sympathicotomy. Twenty-four patients were randomized to receive sympathicotomy using a conventional 5-mm electrocautery hook (hook group) and 22 patients were randomized to the DLET group.
  
  
  RESULTS
  The mean postoperative follow-up period was 8.1 months (range: 1 to 15 months). After surgery the hands of all patients became dry and warm. Mean incision size was 10.6 ± 1.0 in the hook group and 6.5 ± 0.5 mm in the DLET group (p = 0.001). The mean pain score was 1.4 ± 0.6 with hook surgery and 0.9 ± 0.6 with the DLET device (p = 0.016). The mean operative time was longer in the hook group (36.8 ± 3.4 min) than in the DLET group (30.5 ± 3.9 min; p = 0.001). There were no significant differences between the two procedures in terms of hospital stay and compensatory sweating, or patient satisfaction. Pneumothorax occurred in two (8.3%) patients in the hook group and in one (4.5%) patient in the DLET group. None of the patients required chest drainage and none developed Horner syndrome.
  
  
  CONCLUSIONS
  Single-port video-assisted thoracoscopic sympathicotomy using hook or DLET procedures is effective, safe, and minimally invasive method for palmar hyperhidrosis. The DLET device allows a shorter operation time, smaller incision, better cosmetic results, less pain, and better clarity of video, making it suitable for single-port thoracoscopic sympathicotomy.
authors.affiliation: Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
authors.forename: Cheng-Hua
authors.initials: CH
authors.lastname: Jin
authors.affiliation: Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
authors.forename: Kai-Zhong
authors.initials: KZ
authors.lastname: Yu
authors.affiliation: Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Tian
authors.affiliation: Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
authors.forename: Zheng-Chun
authors.initials: ZC
authors.lastname: Mao
authors.affiliation: Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China.
authors.forename: Wei-Yu
authors.initials: WY
authors.lastname: Shen
mesh_terms: D000293:Adolescent; D000328:Adult; D004564:Electrocoagulation / Q000295:instrumentation; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013562:Sympathectomy / Q000295:instrumentation*; D013564:Sympathetic Nervous System / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation*; D055815:Young Adult