Hyperhidrosis VATS sympathectomy

VATS Sympathectomy At Hyperhydrosis Purpose: Thoracic hyperhidrosis, a disease with unknown etiology, is characterized by excessive sweating in palmar, axillary, facial and dorsal area due to increased activity in dermatome innerved by sympathetic chain. Hyperhidrosis affects a person's life directly or indirectly by causing psychosocial problems. In the treatment of hyperhidrosis, conservative medical methods and invasive methods of surgery can be used. The major indication of surgical sympathectomy is palmar and axillary hyperhidrosis which do not respond medical treatment. In the hyperhidrozis, the success after sympathectomy is determined by the fact that the complaints of patients completely disappear and do not repeat after the surgery. In this study patients undergoing thoracoscopic sympathectomy for hyperhydrosis was assessed about the level of sympathectomy, complications, recurrence, compensatory sweating, discharge duration and effects on quality of life.Methods: Study was made in Bezmialem Vakıf Gureba Training and Research Hospital (2010 Foundation University of Bezmialem) with 50 patients who have got palmar and axillary hyperhydrosis. Study was designed retrospective on the data base which was held prospective. The information about age, gender, level of sympathectomy (extracted ganglion number), the surgical morbidity and mortality, length of stay in hospital was found by the patient files. Compansatory sweating and recurrence informations were checked with control examination.Findings: Fifty patients were operated by video assissted thoracoscopic surgery with a total of 102 sympathectomy. One patient was reoperated because of recurrence. 23 patients (46%) were female and 27 patients (54%) were male. Level of sympathectomy was T2-4 for 21 patients (42%), T2-5 for 18 patients (36%), T3-4 for 6 patients (%12), T2 for 3 patients (%6) and T3-5 for 2 patients (%4). Morbidity is %14,7 (15 patients). Pneumothorax developed in 13 patients (%12,7). Bleeding was observed in only one patient which requiring open thoracotomy. And only one patient developed recurrence. The mean duration of hospital stay was 1,68 (1-4) days. There was no mortality. Over 98% success has been achieved with thoracoscopic sympathectomy. Compansatory sweating was seen in 34 patients (68%) and two were severe.Results: Thoracoscopic sympathectomy for treatment of hyperhydrosis is a safe and successful method. And with this method high quality of life and patient satisfaction is achieved.