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1. Scognamillo F, Serventi F, Attene F, Torre C, Paliogiannis P, Pala C, Trignano E, Trignano M: T2-T4 sympathectomy versus T3-T4 sympathicotomy for palmar and axillary hyperhidrosis. Clin Auton Res; 2011 Apr;21(2):97-102

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] T2-T4 sympathectomy versus T3-T4 sympathicotomy for palmar and axillary hyperhidrosis.
  • OBJECTIVE: To evaluate and compare the immediate and long-term outcomes of videothoracoscopic T2-T4 sympathectomy and T3-T4 sympathicotomy for the treatment of palmar and axillary hyperhidrosis.
  • METHODS: Between October 1993 and September 2007, we treated a total of 88 patients affected by palmar and axillary hyperhidrosis.
  • Twenty-four patients underwent T2-T4 sympathectomy with 5-10 mm trocars (Group A), 43 T2-T4 sympathectomy with 2-5 mm trocars (Group B), 15 T3-T4 sympathicotomy with 5-10 mm trocars and 6 T3-T4 ganglion block with 2-5 mm trocars (Group C).
  • The mean operative time, for each side, was 15 min for sympathicotomy and 28 min for sympathectomy.
  • In September 2008, we recontacted 98% of patients (total 86), by telephone, to establish long-term results (follow-up range 1-15 years).
  • RESULTS: In this series, we did not find any significant difference between T2-T4 sympathectomy and T3-T4 sympathicotomy in terms of postsurgical palmar anhidrosis or onset of compensatory hyperhidrosis, while both methods show high efficacy for remission of palmar hyperhidrosis.
  • The slightly higher recurrence rate in our early experience (Group A) can be attributed to the learning curve.
  • Using smaller trocars (2-5 mm), we reduced postsurgical intercostal pain and obtained better aesthetic results and a higher grade of patient's satisfaction.
  • INTERPRETATION: Thoracoscopic approach to hyperhidrosis has evolved in the last few decades with a consequent decrease in side effects.
  • In this series, all patients experienced an improvement in quality of life even in case of recurrence or onset of compensatory hyperhidrosis.
  • Due to these results, the shorter operative time and easier performance of sympathicotomy, we prefer this method.
  • [MeSH-major] Hyperhidrosis / surgery. Sympathectomy / methods. Thoracic Nerves / surgery
  • [MeSH-minor] Female. Follow-Up Studies. Humans. Male. Patient Satisfaction. Thoracic Surgery, Video-Assisted / methods. Thoracic Vertebrae. Treatment Outcome

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  • (PMID = 21243401.001).
  • [ISSN] 1619-1560
  • [Journal-full-title] Clinical autonomic research : official journal of the Clinical Autonomic Research Society
  • [ISO-abbreviation] Clin. Auton. Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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