title: Electrocautery versus Ultracision versus LigaSure in Surgical Management of Hyperhidrosis.
abstract: OBJECTIVE
  The aim of the study was to evaluate the sympathectomy procedures for primary hyperhidrosis in terms of complications and effectiveness.
  
  
  METHODS
  From January 2010 to September 2012 we performed 130 sympathectomies in 65 patients, 27 males (42%) and 38 females (58%). Electrocoagulation was used in 20 procedures (15%), ultrasonic scalpel in 54 (42%), and radiofrequency dissector in 56 (43%). Seven patients (11%) underwent bilateral sympathectomy in the same surgical session, while in 58 (89%) the right surgical approach was delayed 30 days from the first procedure.
  
  
  RESULTS
  We noticed 12 complications (9%): (a) chest pain in 6 patients (4 with electrocoagulation, 1 with ultrasonic scalpel, and 1 with radiofrequency dissector), which disappeared in 20 ± 1 day; (b) paresthesias in 3 electrocoagulation patients, was solved in 23 ± 5 days; (c) bradycardia in 1 ultrasonic patient, normalized in 4th postoperative hour; (d) unilateral relapse in 2 electrocoagulation patients after the second side approach, positively treated in 1 patient by resurgery in video-assisted thoracoscopy (VAT). The quality-adjusted life year and the quality of life evaluation revealed a statistically significant improvement (p = 0.02) in excessive sweating and general satisfaction after surgery, with Ultracision and LigaSure showing better findings than electrocoagulation.
  
  
  CONCLUSIONS
  The latest generation devices offered greater efficacy in the treatment of hyperhidrosis, minimizing complications and facilitating the resumption of normal work and social activity of patients.
authors.affiliation: Department of Thoracic Surgery, University of L'Aquila, "G. Mazzini" Hospital, Teramo, Italy.
authors.forename: Duilio
authors.initials: D
authors.lastname: Divisi
authors.affiliation: Department of Thoracic Surgery, University of L'Aquila, "G. Mazzini" Hospital, Teramo, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Di Leonardo
authors.affiliation: Department of Thoracic Surgery, University of L'Aquila, "G. Mazzini" Hospital, Teramo, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: De Vico
authors.affiliation: Department of Thoracic Surgery, University of L'Aquila, "G. Mazzini" Hospital, Teramo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Crisci
mesh_terms: D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation; D004564:Electrocoagulation / Q000009:adverse effects; D004867:Equipment Design; D005260:Female; D006801:Humans; D006945:Hyperhidrosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D012086:Reoperation; D013525:Surgical Instruments; D013546:Sweating; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D013906:Thoracoscopy; D013997:Time Factors; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D055815:Young Adult