Abstract
Beginning in April 1989, we have performed eight upper thoracic chemical sympathectomies by transthoracic endoscopy. The indications were occlusive arterial disease in four patients and Raynaud's syndrome and palmar hyperhidrosis in two patients each. Transthoracic endoscopy was performed under general anesthesia, through the third costal interspace on the anterior mid-clavicular line. Five ml of phenol were injected into the parietal pleura covering the three proximal thoracic ganglia. The duration of thoracic drainage was 24 hours. The postoperative course was uneventful except for one case of subcutaneous emphysema and transient Horner's syndrome in three instances. There were no initial failures. Because of its simplicity and the short hospitalization period, chemical sympathectomy by transthoracic endoscopy constitutes a valuable alternative to conventional surgery. This technique is, however, limited in the case of antecedent pleuropulmonary disorders.
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References
ALBERT D, BERTOUX JP, VERMYNCK JP, et al. Indications et résultats de la sympathectomie dorsale dans les syndromes vasculaires du membre supérieur.J Chir 1979;116:187–192.
GRUSS JD. Indications opératoires et résultats de la sympathectomie thoracique.J Chir 1976;112:307–314.
WEALE FE. Upper thoracic sympathectomy by transthoracic electrocoagulation.Br J Surg 1980;67:71–72.
KUX M, FRITSCH A, KOKOSCHKA R. Endoscopic thoracic sympathectomy for the treatment of Raynaud phenomena and disease.Eur Surg Res 1976;8:32–33.
KUX M. Thoracic endoscopic sympathectomy in palmar and axillary hyperhidrosis.Arch Surg 1978;113:264–266.
HORGAN K, FLANAGAN S, DUIGNAN PJ, et al. Palmar and axillary hyperhidrosis treated by sympathectomy by transthoracic endoscopic electrocoagulation.Br J Surg 1984;12:10.
MALONE PS. Endoscopic thoracic sympathectomy in the treatment of upper limb hyperhidrosis.Ann R Coll Surg Engl 1986;68:93–94.
GUERIN JC, DEMOLOMBE S, BRUDON JR. Sympatholyse thoracique par thoracoscopie: a propos de 15 cas.Rev Mal Resp 1990;7:327–330.
ROOS DB. Sympathectomy for the upper extremities anatomy, indications and techniques. In: RUTHERFORD RB (ed).Vascular Surgery. Philadelphia: W. B. Saunders, 1977, pp 623–628.
ELLIS H. Transaxillary sympathectomy in the treatment of hyperhidrosis of the upper limb.Am Surg 1979;45:546–551.
COULON KC, KEAVENCY TV. Upper dorsal sympathectomy for palmar hyperhidrosis.Br J Surg 1987;74:651.
ADAR R. Palmar hyperhidrosis and its surgical treatment.Ann Surg 1977;186:34–41.
MATASSI R, MIELE F, DANGELO F. Thoracic sympathectomy: review of indications, results and surgical techniques.J Cardiovasc Surg 1987;4:336–339.
THUONG XUAN N, TU HUYNH V. Traitement de l'hyperhidrose des mains par injection transcutanée de sérum chaud dans les ganglions sympathiques thoraciques supérieurs.Neurochirurgie 1979;25:189–191.
WILKINSON HA. Radiofrequency percutaneous upper thoracic sympathectomy: technique and review of indications.N Engl J Med 1984;311:34–36.
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Bardaxoglou, E., Reigner, B., Enon, B. et al. Transthoracic endoscopy for upper thoracic chemical sympathectomy. Annals of Vascular Surgery 6, 390–392 (1992). https://doi.org/10.1007/BF02008799
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DOI: https://doi.org/10.1007/BF02008799