Thoracic sympathectomy under video mediastinoscopy for palmar hyperhidrosis: Report of 55 cases / 中国微创外科杂志

ABSTRACT

Objective To explore the feasibility of thoracic sympathectomy under video mediastinoscopy (VM) for palmar hyperhidrosis. Methods Operations on 55 patients with palmar hyperhidrosis were performed under general anesthesia with double lumen endotracheal tube placement. The patients were maintained in the 30?～45? semi-sitting position, with abduction of both arms to 90?. The VM entered the thoracic cavity via the third intercostal space on the anterior axillary line. The T 2～T 4 sympathetic ganglions were resected by electrocautery. Results Hyperhidrosis disappeared postoperatively in all the cases. The temperature of patients' both hands increased by 1.5～3 ℃,with their both hands becoming dry and warm. The operation time was 20～40 min (mean, 30 min) and the hospital stay was 3～7 d (mean, 4 d). No severe complications occurred. Mild subcutaneous emphysema along with pneumothorax was found in 3 cases and compensatory hyperhidrosis in the trunk happened in 5 cases. Conclusions Thoracic sympathectomy under VM is less invasive and simpler than that under video-assisted thoracoscopic surgery (VATS) in the treatment of palmar hyperhidrosis, being a feasible alternative.