Electric vs. harmonic scalpel in treatment of primary focal hyperhidrosis with thoracoscopic sympathectomy.
BACKGROUND
Hyperhidrosis is defined as excessive sweating beyond the physiologic needs of a person. Palmar hyperhidrosis in the adolescent period may have an impact on school work and may cause psychological problems. Thoracoscopic sympathectomy is now used routinely to treat patients with disabling primary hyperhidrosis or facial blushing.


METHODS
From January 2008 to December of 2009 bilateral thoracoscopic sympathectomy Th2-Th4 was performed to 79 patients aged from 17 to 55, who suffered from palmar, axillar or craniofacial hyperhidrosis. For the first 39 patients (group A) thoracoscopic sympathectomy was performed using electric scalpel and for the next 40 patients (group B) thoracoscopic sympathectomy was performed using harmonic scalpel.


RESULTS
Based on our results we did not find any significant differences between electric or harmonic scalpel usages for thoracoscopic sympathectomy. Moreover, there was no significant difference between complications and the severity of pain, with slightly higher intensity of pain with harmonic scalpel usage. Both electric and harmonic scalpel provided adequate treatment for primary hyperhidrosis, with the fact that non-disposable electric scalpel costs were less than that of the disposable harmonic scalpel.


CONCLUSIONS
Sympathectomy should be preferred for palmar hyperhidrosis treatment, as it is much technically shorter, simpler to implement, and also easier to learn. Thoracoscopic sympathectomy is safe and effective for the treatment of primary palmar hyperhidrosis in the adolescent period without any major side effects.
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Ivan
I
Kuhajda
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Dejan
D
Durić
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Milos
M
Koledin
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Miroslav
M
Ilic
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Drosos
D
Tsavlis
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Ioannis
I
Kioumis
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Katerina
K
Tsirgogianni
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Konstantinos
K
Zarogoulidis
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
John
J
Organtzis
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Christoforos
C
Kosmidis
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Sofia
S
Baka
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Ilias
I
Karapantzos
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Chrysanthi
C
Karapantzou
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Kosmas
K
Tsakiridis
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Nikolaos
N
Sachpekidis
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Paul
P
Zarogoulidis
1 Clinic for Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; 2 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 3 Surgery Department, 4 Oncology Department, "Interbalkan" European Medical Center, Thessaloniki, Greece ; 5 Department of Ear, Nose and Throat Diseases, 6 Thoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece.
Milorad
M
Bijelovic
Hyperhidrosis; thoracoscopic sympathectomy