title: Semi-Fowler vs. lateral decubitus position for thoracoscopic sympathectomy in treatment of primary focal hyperhidrosis.
abstract: OBJECTIVE
  The aim of this study is to compare usefulness of Semi-Fowler position vs. lateral decubitus position for thoracoscopic sympathectomy in treatment of primary focal hyperhidrosis.
  
  
  METHODS
  From January 2009 to January 2010, 263 consecutive patients with palmar and axillar hyperhidrosis underwent thoracoscopic sympathectomy Th2-Th4. Patients were divided into two groups: group A (n=133) underwent thoracoscopic sympathectomy through lateral decubitus using double lumen endotracheal intubation, and group B (n=130) underwent thoracoscopic sympathectomy through Semi-Fowler supine position (semi sitting with arm abducted) using single lumen endotracheal intubation without insufflation of CO2, but with short apnea period. All operations were performed through two 5 mm operating ports, videothoracoscopic camera 0° and endoscopic ultrasound activated harmonic scalpel.
  
  
  RESULTS
  There were 107 males and 156 females with median age 30.31±8.35 years. Two groups were comparable in gender, age, severity of sweating. All operations were successfully performed with no complications or perioperative morbidity. For group A average operation time for both sides was 31.2±3.87 min and for group B average time was 14.19±4.98 min. In group B apnea period per one lung lasts 2.86±1.15 min and during that period observed saturation was 92.65%±5.66% without significant cardiorespiratory disturbances. Pleural drains were taken off on operation table after forced manually lung reexpansion. Patients were discharged from hospital for few hours, after the operation and radiologic confirmation of complete lung reexpansion.
  
  
  CONCLUSIONS
  Based on this data (shorter operating time, lack of incomplete lung collapse, insignificant apnea and better reexpansion of lungs) we concluded that thoracoscopic sympathectomy through Semi-Fowler supine position is highly effective and easy to perform for primary hyperhidrosis.
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Kuhajda
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Dejan
authors.initials: D
authors.lastname: Djuric
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Koledin
authors.initials: K
authors.lastname: Milos
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Milorad
authors.initials: M
authors.lastname: Bijelovic
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Misel
authors.initials: M
authors.lastname: Milosevic
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Dejan
authors.initials: D
authors.lastname: Ilincic
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Ilic
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Bojan
authors.initials: B
authors.lastname: Koledin
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Danijela
authors.initials: D
authors.lastname: Kuhajda
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Kosmas
authors.initials: K
authors.lastname: Tsakiridis
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Andreas
authors.initials: A
authors.lastname: Mpakas
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Zarogoulidis
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kioumis
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Sofia
authors.initials: S
authors.lastname: Lampaki
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Paul
authors.initials: P
authors.lastname: Zarogoulidis
authors.affiliation: 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia.
authors.forename: Milana
authors.initials: M
authors.lastname: Komarcevic
keywords: Primary hyperhidrosis; Semi-Fowler position; minimal invasive surgery; thoracoscopic sympathectomy