Objective
Postoperative compensatory sweating (PCS) is an important problem impacting on quality of life for patients after endoscopic thoracic sympathectomy (ETS). The present study investigated whether intraoperative palmar temperature and blood flow are useful for assessing PCS after ETS. Methods: Retrospectively, results were evaluated for ETS in 27 consecutive patients with primary palmar hyperhidrosis between 1996 and 2002. For all patients, bilateral nerve conduction to the palms was interrupted. The relationship between the range of PCS and intraoperative changes in palmar temperature and blood flow was investigated. Results: PCS developed in all cases. After completion of ETS, mean blood flow and temperature increased respectively. Significant correlations were found between the range of PCS and increases in palmar temperature (p<0.05) and blood flow (p<0.05). Conclusion: Intraoperative monitoring of increases in palmar temperature and blood flow may be useful in patients with primary hyperhidrosis, to predict the range of PCS after ETS.
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Lai YT, Yang LH, Chio CC, Chen HH. Complications in patients with palmar hyperhidrosis treated with transthoracic endoscopic sympathectomy. Neurosurgery 1997; 41: 110–5.
Chiou TS, Chen SC. Intermediate-term results of endoscopic transaxillary T2 sympathectomy for primary palmar hyperhidrosis. Br J Surg 1999; 86: 45–7.
Gossot D, Galetta D, Pascal A, Debrosse D, Caliandro R, Girard P, et al. Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Ann Thorac Surg 2003; 75: 1075–9.
Lin TS, Huang LC, Wang NP, Lai CY. Video-assisted thoracoscopic T2 sympathetic block by clipping for palmar hyperhidrosis: Analysis of 52 cases. J Laparoendosc Adv Surg Tech A 2001; 11: 59–62.
Riet M, Smet AA, Kuiken H, Kazemier G, Bonjer HJ. Prevention of compensatory hyperhidrosis after thoracoscopic sympathectomy for hyperhidrosis. Surg Endosc2001; 15: 1159–62.
Lin CC, Mo LR, Lee LS, Ng SM, Hwang MH. Thoracoscopic T2-sympathetic block by clipping: A better and reversible operation for treatment of hyperhidrosis palmaris: Experience with 326 cases. Eur J Surg 1998; Suppl: 13–6.
Chung IH, Oh CS, Koh KS, Kim HJ, Paik HC, Lee DY. Anatomic variations of the T2 nerve root (including the nerve of Kuntz) and their implications for sympathectomy. J Thorac Cardiovasc Surg 2002; 123: 498–501.
Lindquist C, Fedorcsak I, Steig PE. Electrophysiological aid in high thoracic sympathectomy for palmar hyperhidrosis. Neurosurgery 1989; 24: 449–52.
Sano T, Fukushige T, Miyagawa Y, Yamada S, Kano T. Intraoperative assessment by laser-Doppler skin blood flowmetry of the efficacy of endoscopic thoracic sympathectomy (Eng abstr). Masui 1999; 48: 481–6.
Saiz-Sapena N, Vanaclocha V, Panta F, Kadri C, Torres W. Operative monitoring of hand and axillary temperature during endoscopic superior thoracic sympathectomy for the treatment of palmar hyperhidrosis. Eur J Surg 2000; 166: 65–9.
Tsai JC, Lim KB, Lin SY, Kao MC. Thermographie study of palmar and facial skin temperature of hyperhidrosis patients before and after thoracic sympathectomy. J Formos Med Assoc 2000; 99: 466–71.
Wu JJ, Hsu CC, Liao SY, Liu JC, Shih CJ. Contralateral temperature change of the finger surface during video endoscopic sympathectomy for palmar hyperhidrosis. J Auton Nerv Syst 1996; 59: 98–102.
Ng I, Yeo TT. Palmar hyperhidrosis: Intraoperative monitoring with laser Doppler blood flow as a guide for success after endoscopic thoracic sympathectomy. Neurosurgery 2003; 52: 127–30.
Kao MC. Video endoscopic sympathectomy using a fiberoptic CO2 laser to treat palmar hyperhidrosis. Neurosurgery 1992; 30: 131–5.
Chiou SM, Chen SC. Sensitivity, specificity and predictive value of intra-operative elevation of hand temperature to ensure a successful T2-sympathectomy in patients with palmar hyperhidrosis. Acta Neurochir (Wien) 1999; 141: 855–9.
Chou SH, Lee SH, Kao EL. Thoracic endoscopic T2-T3 sympathectomy in palmar hyperhidrosis: Experience of 112 cases. Surg Today 1993; 23: 105–7.
Zacherl J, Huber ER, Imhof M, Pias EG, Herbst F, Fugger R. Long-term results of 630 thoracoscopic sympathictomies for primary hyperhidrosis: The Vienna experience. Eur J Surg 1998; Suppl: 43–6.
Drott C, Gothberg G, Claes G. Endoscopie procedures of the upper-thoracic sympathetic chain. A review. Arch Surg 1993; 128: 237–41.
de Campos JR, Kauffman P, Werebe Ede C, Andrade Filho LO, Kusniek S, Wolosker N, et al. Quality of life, before and after thoracic sympathectomy: Report on 378 operated patients. Ann Thorac Surg 2003; 76: 886–91.
Daseler EH, Anson BJ. Surgical anatomy of the subclavian artery and its branches. Surg Gynecol Obstet 1959; 108: 149–74.
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Fujita, T., Mano, M., Nishi, H. et al. Intraoperative prediction of compensatory sweating for thoracic sympathectomy. Jpn J Thorac Caridovasc Surg 53, 481–485 (2005). https://doi.org/10.1007/s11748-005-0091-x
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DOI: https://doi.org/10.1007/s11748-005-0091-x