title: Single stage bilateral uniportal videothoracoscopic sympathicotomy for hyperhidrosis: can it be managed as an outpatient procedure?
abstract: BACKGROUND
  The videothoracoscopic approach is minimally invasive with benefits that include less postoperative pain and shorter hospital stay. It is also a safe procedure which can be performed on an outpatient basis.
  
  
  OBJECTIVE
  To determine whether videothoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure.
  
  
  METHODS
  Between July 2005 and October 2015, a total of 92 patients underwent bilateral and single port thoracoscopic sympathicotomy in our department on an outpatient basis. The level of sympathicotomy was T2 in 2 (2.2%) patients, T2 to T3 in 31 (33%) patients, T2 to T4 in 46 (50%) patients and T3 to T4 in 12 (13%) patients. Demographic data, length of postoperative stay, substitution index (SI), admission rate (AR) and readmission rate (RR), complications and patient satisfaction were reviewed retrospectively.
  
  
  RESULTS
  Two (2.2%) patients suffered from chest pain, while 4 (4.3%) patients complained about pain at the port site. Mean discharge time after surgery was 5.1 h (range: 4-6 h), mean duration of hospital stay was 0.15 days (0-3 days) postoperatively and the mean operation time was 43.6 min (15-130 min). In 8 (8.6%) patients, pneumothorax was detected on postoperative chest X-ray, while 5 (5.4%) patients required chest tube drainage. Mild or moderate compensatory sweating developed in 32 (34.7%) patients. No recurrence was observed, and the satisfaction rate was 96.7%. Substitution index and admission rate were 91.3% and 11% respectively, while RR was 0%.
  
  
  CONCLUSIONS
  Bilateral video-assisted thoracoscopic sympathicotomy can be performed safely in most patients as an outpatient procedure.
authors.affiliation: Department of Thoracic Surgery, School of Medicine, Istanbul Acıbadem University, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demirkaya
authors.affiliation: Department of Thoracic Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Ezel
authors.initials: E
authors.lastname: Erşen
authors.affiliation: Department of Thoracic Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Kılıç
authors.affiliation: Department of Thoracic Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Hasan Volkan
authors.initials: HV
authors.lastname: Kara
authors.affiliation: Department of Thoracic Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Mehlika
authors.initials: M
authors.lastname: İşcan
authors.affiliation: Department of Thoracic Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Kaynak
authors.affiliation: Department of Thoracic Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Akif
authors.initials: A
authors.lastname: Turna
keywords: outpatient; sympathicotomy; uniportal; video-thoracoscopy