A case of difficult endoscopic thoracic sympathectomy caused by thick-sticky pleural cavity

Introduction of 3 cases of endoscopic thoracic sympathectomy with thick-sticky pleural cavity to treat hyperhidrosis. These patients were operated under endotracheal anesthesia with Carten tube. The patients lied on one side, prone 450. There were 2 cases of right thick-sticky pleural cavity, 1 case of left thick-sticky pleural cavity. All of 3 cases were put drain in pleural cavity after gas discharge and fluid suck, following-up after 12 hours, taking thoracic X-ray and withdrawing drainage. A good operative result was observed in 3 cases

Treating hyperhidrosis by endoscopic thoracic sympathectomy at Hospital No 103

Prospective study on 26 patients with hyperhidrosis due to overactive sympathetic system treated at Department B12, Hospital No 103. Results: there were 3 patients with pleural adhesions discovered by ultrasound. Before operation, 69.2% patients had cold and wet hands, but after operation, 88.4% patients had warm hands. During operations, severe pleural adhesions were in 9.6% patients, and pulmonary tissue didn’t flatten completely in 19.2% patients. The mean time of operations was 16.45 minutes for each side. The time of unilateral sympathectomy of 10-15 minutes was most common. There were many advantages of endoscopic surgery because it can help to assess sympathetic ganglion chains, and give high rate of success (98.4%). Carlen's tube was used for tracheal intubation. Postoperative pleural drainage wasn’t used. Compensational hyperhidrosis occurred in 11.4% patients.