Abstract
This report provides a detailed description of the operative technique, anatomical variations, and surgical pitfalls of supraclavicular upper dorsal sympathectomy for palmar hyperhidrosis, based on experience with performance of a simultaneous bilateral operation in 155 patients between 1971 and 1976. The denervation is preganglionic and is confined to removal of T2 and T3 ganglia. Frozen section examination of the specimen is useful in preventing technical failure. Persistent Horner's syndrome occurred in 8% of the patients and is the main complication of the procedure. The advantages of the supraclavicular approach are ease of performing a bilateral procedure, few pulmonary complications because of the extrapleural approach, minimal overall morbidity, and good results in relieving palmar hyperhidrosis.
Résumé
Ce travail est une étude détaillée de la technique opératoire, des variations anatomiques et des écueils de la sympathectomie dorsale haute par voie sus-claviculaire pour hyperhidrose palmaire. L'opération, bilatérale, a été faite chez 155 malades entre 1971 et 1976. La résection, limitée aux 2è et 3è ganglions thoraciques, réalise une énervation préganglionnaire. La biopsie extemporannée est utile pour éviter les échecs techniques. La principale complication est un Claude-Bernard-Horner définitif (8% des opérés). Les avantages de la voie d'abord sus-claviculaire sont: la facilité pour l'opération bilatérale, la rareté des complications pulmonaires puisque l'abord est extrapleural, la faible morbidité et les bons résultats, l'hyperhidrose palmaire étant soulagée.
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Kurchin, A., Zweig, A., Adar, R. et al. Upper dorsal sympathectomy for palmar primary hyperhidrosis by the supraclavicular approach. World J. Surg. 1, 667–673 (1977). https://doi.org/10.1007/BF01556207
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DOI: https://doi.org/10.1007/BF01556207