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Endoscopic Sympathetic Surgery

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Minimally Invasive Thoracic and Cardiac Surgery

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Abstract

Endoscopic thoracic sympathectomy (ETS) is an effective treatment option for patients suffering from primary hyperhidrosis, facial blushing, and various vascular disorders.

A thorough medical checkup aims to rule out other causes of the disturbance. Conservative treatments for hyperhidrosis patients range from topical aluminum chloride solutions, herbal therapies, and anticholinergic drugs to botox injections. Quantitative assessment of the amount and degree of sweating is dependent on the environment as well as the physical and emotional situation and therefore difficult to accomplish. Most authors apply disease-specific questionnaires and quality of life instruments.

Various surgical techniques are described in this chapter, ranging from resection over cutting to clip application to achieve anhidrosis. The clipping method offers the potential of reversal surgery primarily for patients who suffer from unbearable compensatory sweating. This side effect of ETS surgery is frequently observed, but diminishes quality of life in only 5% of patients. Intra- and postoperative complications are rare, but can be life threatening. Adequate training of surgeons, informed consent of patients, and postoperative follow-up are mandatory.

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Acknowledgment

The authors want to thank c.m. Catherine Novak for her support in editing the manuscript and providing tables and reference list.

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Authors and Affiliations

  1. Department of Surgery, St. Josef Hospital, Auhofstrasse 189, 1130, Vienna, Austria

    Georg Bischof M.D.

  2. Department of Surgery, Medical University of Vienna (MUW), Währinger Gürtel 18-20, 1090, Vienna, Austria

    Peter Panhofer M.D. & Christoph Neumayer M.D.

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  1. Georg Bischof M.D.
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  2. Peter Panhofer M.D.
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  3. Christoph Neumayer M.D.
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Correspondence to Georg Bischof M.D. .

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Editors and Affiliations

  1. Klinik Hirslanden, Thoraxzentrum Zürich, Witellikerstr. 40, Zürich, 8008, Switzerland

    Rolf Gilbert Carl Inderbitzi

  2. , Division of General Thoracic Surgery, University Hospital Berne
, Freiburgstr. 2010, Berne, 3010, Switzerland

    Ralph Alexander Schmid

  3. , Department of Cardio-Thoracic Surgery, University of Pisa, Via Paradisa 2, Pisa, 56100, Italy

    Franca M. A. Melfi

  4. St. Mary's Hospital, Department of Cardio-Thoracic Surgery, Imperial College Healthcare NHS Trust, Praed Street, LONDON, W2 1NY, United Kingdom

    Roberto Pasquale Casula

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Bischof, G., Panhofer, P., Neumayer, C. (2012). Endoscopic Sympathetic Surgery. In: Inderbitzi, R., Schmid, R., Melfi, F., Casula, R. (eds) Minimally Invasive Thoracic and Cardiac Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11861-6_29

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