Simpatectomía dorsal bilateral en el tratamiento de la hiperhidrosis esencial: efectos a los 3 años sobre la función pulmonar

[Video-assisted thoracic surgery, lung transplantation and mediastinitis: major issues in thoracic surgery in 2010]

We reviewed the major issues in thoracic surgery relating to the advances made in our specialty in 2010. To do this, the 43(rd) Congress of the Spanish Society of Pneumology and Thoracic Surgery held in La Coruña and the articles published in the Society's journal, Archivos de Bronconeumología, were reviewed. The main areas of interest were related to the development of video-assisted thoracic surgery, lung transplantation and descending mediastinitis. The new tumor-node-metastasis (TNM) classification (7(th) edition), presented last year, was still a topical issue this year. The First Forum of Thoracic Surgeons and the Update in Thoracic Surgery together with the Nurses' Area have constituted an excellent teaching program.

Single incision thoracoscopic sympathectomy for palmar and axillary hyperhidrosis

BACKGROUND

Primary hyperhidrosis is characterized by excessive sweating beyond physiological needs. It is a common disease (incidence 2.8%) that causes intense discomfort for patients. In the last decade, advantages of Single-Incision Thoracoscopic Sympathectomy have become clear, particularly in decreasing morbidity of sympathectomy.

PATIENTS AND METHODS

From January 2010 to December 2012, 39 patients (29 females and 10 males) with primary palmar or axillary hyperhidrosis were treated by thoracoscopic sympathectomy. The age ranged from 18 to 40 years with a mean of 26.28 years. We used single incision thoracoscopic electrocoagulation through 10 mm incision for thoracic sympathetic chain (T2-T4).

RESULTS

The mean follow-up was 23.6 ± 14.2 months (range = 4-24 months). A total of 97.42% of patients were satisfied with the results. A total of 72.5% of patients had cure, one patient (2.5%) and another patient (2.5%) presented with recurrent axillary hyperhidrosis. The morbidity was 10.2% with no mortality. Percentage of compensatory sweating and gustatory sweating were 5.1% (p = .353) and 2.5% (p = .552), respectively. The result of sympathectomy in patients with both palmar and axillary hyperhidrosis was significantly better (17, 43.58%) compared to palmar type (14, 35.89%) or axillary type (7, 17.94%).

CONCLUSION

Thoracoscopic sympathectomy is a simple, safe, and cost-effective therapy with good results and low complications.