Thoracoscopic sympathectomy for palmar hyperhidrosis - Ablate or resect?

Citation
M. Hashmonai et al., Thoracoscopic sympathectomy for palmar hyperhidrosis - Ablate or resect?, SURG ENDOSC, 15(5), 2001, pp. 435-441
Citations number
83
Categorie Soggetti
Surgery
Journal title
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES
ISSN journal
09302794 → ACNP
Volume
15
Issue
5
Year of publication
2001
Pages
435 - 441
Database
ISI
SICI code
0930-2794(200105)15:5<435:TSFPH->2.0.ZU;2-J
Abstract
Background: Upper thoracoscopic sympathectomy, obtained either by ablation or resection of the appropriate ganglia, is now the preferred treatment for primary palmar hyperhidrosis. Therefore, we undertook a review to compare the relative efficacy of these two techniques. Methods: A Medline search was performed for the years 1974-99 to identify a ll published studies of thoracoscopic sympathectomy for hyperhidrosis. Results: In all, 33 studies were identified and divided into two groups-abl ation and resection. When the resection method was used, the immediate succ ess rate was 99.76%, whereas the ablation method achieved dry hands in 95.2 % of cases (p = 0.00001). Palmar sweating recurred in 0% of patients treate d via resection and 0-4.4% treated with ablation. Ptosis was noted in 0.92% of cases after ablation and in 1.72% after resection (p = 0.017). Conclusions: Resection yields superior results, yet the majority of surgeon s ablate, probably because it is easier, re-quires a shorter operating time , leads to fewer cases of Homer's syndrome, and because resympathectomy eve ntually overcomes initial failure.