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I LAVORI SULL'IPERIDROSI
SONO IN PROGRESSIONE SECONDO L'EVOLUZIONE DELLA TECNICA E DEI NUMERI DEI SOGGETTI OPERATI
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1:
Results, side effects and complications after thoracoscopic sympathetic
block by clamping : The Monza clinical experience.
Clin Auton Res. 2008 Apr 14; [Epub ahead of print]
PMID: 18414773 [PubMed - as supplied by publisher]
Results, side effects and complications after thoracoscopic sympathetic block by clamping : The Monza clinical experience.Division of Thoracic Surgery, Dept. of Thoracic and Cardiovascular Surgery, Universitary San Gerardo Hospital, Via Pergolesi 33, Monza, Milan, Italy, jlorenz@libero.it. BACKGROUND: Video-endoscopic sympathectomy is the current treatment of choice for severe primary hyperhidrosis. Because of the possible post-surgical side effects, the procedure is carried out using removable endoclips that block sympathetic nerve transmission. This study describes the short and "mid-term" side effects and complications of this method for the treatment of palmar, axillary, and facial hyperhidrosis. MATERIALS AND METHODS: Two hundred and ninety-four sympathectomies were carried out between September 2003 and June 2006 and followed-up after 17 months. Patients with isolated facial hyperhidrosis were clamped at the T2-3 level clamping. Patients with isolated axillary hyperhidrosis were clamped at the T3-4 level. RESULTS: All patients with palmar and palmar-axillary hyperhidrosis were completely satisfied after clamping at the third thoracic ganglion (T3) level. Immediate complete recovery was achieved in 98% of patients post-surgery. Major complications were Horner's syndrome (1%) and pneumothorax (3%). Compensatory sweating occurred in 22%. No cases of gustatory sweating were reported. All patients were "satisfied" with their results and no patients requested removal of the clips. INTERPRETATION: Thoracoscopic sympathecotomy clamping is a successful treatment for hyperhidrosis. Local hyperhydrosis does not reoccur after 17 months, but there is some degree of compensatory hyperhidrosis. PMID: 18414773 [PubMed - as supplied by publisher]
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[Thoracic sympathetic block by clamping in the treatment of primary
hyperhidrosis: indications and results in 281 patients]
Minerva Chir.
2006 Dec;61(6):473-81.
Italian.
PMID: 17211352 [PubMed - indexed for MEDLINE]
[Thoracic sympathetic block by clamping in the treatment of primary hyperhidrosis: indications and results in 281 patients]
[Article in Italian]
Divisione di Chirurgia Toracica, Dipartimento di Chirurgia Cardiotoracica, A.O. San Gerardo, Monza, (Mi), Italy. jlorenz@libero.it AIM: Hyperhidrosis is a disabling troublesome characterized by excessive perspiration that produces a significant social and professional deficit for patients. It main involves the palmar sides of hands and feet, axillae, face and, with a lesser incidence, trunk and scalp. Thoracoscopic sympathectomy represents the best approach for this disorder. The aim of our prospective study is to assess the outcome, the safety and efficacy after thoracoscopic sympathetic block by clipping in the treatment of primary hyperhidrosis. METHODS: Between september 2002 and april 2005, 281 patients (117 female and 164 male, with a mean age of 28 years) underwent Endoscopic Thoracic Sympathectomy (ETS) to treat hyperhidrosis with palmar, axillar, facial and widespread localization. RESULTS: There were no deaths or major intra-operative problems. There was no conversion to open surgery. During intermediate and long-term follow up we obtained excellent results and few complications. In 3 patients (1.06%) we noted a major complication (Horner's Syndrome), but one patient only had the surgical operation reversed; compensatory sweating occurred in 61 individuals (21.7%). Gustatory sweating occurred in no patient. CONCLUSIONS: The clipping of the thoracic sympathetic chain is a reversible surgical technique considered safe and effective. Despite of an incidence of complications and/or compensatory sweating and according to our operatory results, we conclude that the sympathetic block by clamping is the elective treatment for hyperhidrosis. PMID: 17211352 [PubMed - indexed for MEDLINE]
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5:
Endoscopic thoracic sympathectomy by clamping in the treatment of social
phobia: the Monza experience.
Minerva Chir.
2006 Oct;61(5):417-20.
PMID: 17159750 [PubMed - indexed for MEDLINE]
Endoscopic thoracic sympathectomy by clamping in the treatment of social phobia: the Monza experience.Division of Thoracic Surgery, San Gerardo dei Tintori Hospital, Via Pergolesi 33, 20052 Monza, Italy. jlorenz@libero.it AIM: Facial blushing represents the peculiar symptom in social phobia and is defined as the ''hallmark of embarrassment''. At present, endoscopic thoracic sympathectomy (ETS) is the technique only able to guarantee long-term results in the treatment of sympathetic disorders. The aim of our study was to evaluate results, complications and the true value of 52 ETSs by two-port approach with the use of endoclips in patients with isolated facial blushing or in association with hyperhidrosis. METHODS: A retrospective review of 52 subjects who underwent standard ETS by clamping between September 2002 and April 2005 was carried out. This surgical practice was performed in 26 cases (50%) for isolated facial blushing only and in other 26 cases (50%) for facial blushing associated to hyperhidrosis with changeable localizations. Under endoscopic guidance we operated an endoscopic sympathetic block (ESB) with interruption of the inter-ganglion trunk at the level of T2-T3 in 51 patients (98.07%). In 1 patient (1.92%) we performed a sympathetic block with the complete exclusion of T3 thoracic ganglion. RESULTS: There were no intra and postoperative deaths. The effect rate was excellent in all patients with early complications in one patient (1.92%) only. CONCLUSIONS: ETS by clamping is safe and effective. Patients referred an high satisfaction in terms of complications and quality of life; specific early and late diseases are negligible. PMID: 17159750 [PubMed - indexed for MEDLINE]
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