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1. Atkinson JL, Fode-Thomas NC, Fealey RD, Eisenach JH, Goerss SJ: Endoscopic transthoracic limited sympathotomy for palmar-plantar hyperhidrosis: outcomes and complications during a 10-year period. Mayo Clin Proc; 2011 Aug;86(8):721-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endoscopic transthoracic limited sympathotomy for palmar-plantar hyperhidrosis: outcomes and complications during a 10-year period.
  • OBJECTIVE: To review surgical results of endoscopic transthoracic limited sympathotomy for palmar-plantar hyperhidrosis during the past decade.
  • PATIENTS AND METHODS: We retrospectively reviewed 155 consecutive patients who underwent surgery from June 30, 2000, through December 31, 2009, for medically refractory palmar-plantar hyperhidrosis using a technique of T1-T2 sympathotomy disconnection, designed for successful palmar response and minimization of complications.
  • RESULTS: Of the 155 patients, 44 (28.4%) were male, and 111 (71.6%) were female; operative times averaged 38 minutes.
  • No patient experienced Horner syndrome, intercostal neuralgia, or pneumothorax.
  • The only surgical complication was hemothorax in 2 patients (1.3%); in 1 patient, it occurred immediately postoperatively and in the other patient, 10 days postoperatively; treatment in both patients was successful.
  • All 155 patients had successful (warm and dry) palmar responses at discharge.
  • Long-term follow-up (>3 months; mean, 40.2 months) was obtained for 148 patients (95.5%) with the following responses to surgery: 96.6% of patients experienced successful control of palmar sweating; 69.2% of patients experienced decreased axillary sweating; and 39.8% of patients experienced decreased plantar sweating.
  • At follow-up, 5 patients had palmar sweating (3 patients, <3 months; 1 patient, 10-12 months; 1 patient, 16-18 months).
  • Compensatory hyperhidrosis did not occur in 47 patients (31.7%); it was mild in 92 patients (62.2%), moderate in 7 patients (4.7%), and severe in 2 patients (1.3%).
  • CONCLUSION: In this series, a small-diameter uniportal approach has eliminated intercostal neuralgia.
  • Selecting a T1-T2 sympathotomy yields an excellent palmar response, with a very low severe compensatory hyperhidrosis complication rate.
  • The low failure rate was noted during 18 months of follow-up and suggests that longer follow-up is necessary in these patients.
  • [MeSH-major] Foot Dermatoses / surgery. Ganglia, Sympathetic / surgery. Hand Dermatoses / surgery. Hyperhidrosis / surgery. Sympathectomy / statistics & numerical data. Thoracoscopy / statistics & numerical data
  • [MeSH-minor] Adult. Aged. Ambulatory Surgical Procedures / statistics & numerical data. Causality. Comorbidity. Female. Follow-Up Studies. Galvanic Skin Response. Hemothorax / epidemiology. Hemothorax / etiology. Humans. Male. Middle Aged. Retrospective Studies. Skin Temperature. Sweating. Treatment Outcome

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  • [CommentIn] Mayo Clin Proc. 2011 Aug;86(8):717-8 [21803952.001]
  • [ErratumIn] Mayo Clin Proc. 2011 Nov;86(11):1126
  • (PMID = 21803954.001).
  • [ISSN] 1942-5546
  • [Journal-full-title] Mayo Clinic proceedings
  • [ISO-abbreviation] Mayo Clin. Proc.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC3146372
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