Thoracoscopic sympathetic trunk clipping for craniofacial hyperhidrosis: Analysis of 10 cases / 中国微创外科杂志

ABSTRACT

Objective To investigate the feasibility of video-assisted thoracoscopic sympathetic trunk clipping in the treatment of craniofacial hyperhidrosis. Methods A total of 10 patients were operated on under general anesthesia with double-lumen endotracheal intubation. The patients were placed in lateral recumbent position with one-lung ventilation. A 7 mm trocar and a 4.5 mm trocar were inserted at the 2~3 intercostal space on the midaxillary line and at the 4~5 intercostal space on the posterior axillary line, respectively, to introduce surgical instruments and thoracoscopic camera. Alongside the sympathetic chain, the sympathetic nerve trunk immediately below the second costal margin was blocked with small-sized titanium clips. Then the lung was inflated and the incision sutured. Afterwards, the procedure in the contralateral hemithorax was performed using the same method. Results The operating time was 55~130 min (mean, 110 min). Symptoms of craniofacial hyperhidrosis disappeared in the 10 patients, all of who were satisfied with curative results. The postoperative hospital stay was 2~3 days. Neither Horner’s syndrome nor other serious complications were observed. Seven of the patients developed slight compensation hyperhidrosis in their chest, abdomen, back or legs. All the patients had normally returned to work and physical exercises in 7~10 days. Postoperative follow-up for 1~9 months (mean,6.3 months) in all the patients found no recurrence. Conclusions Video-assisted thoracoscopic block of sympathetic trunk below the second costal margin for craniofacial hyperhidrosis is safe and effective.