CT-guided Thoracic Sympathicolysis versus VATS Sympathectomy in the Therapeutic Concept for Severe Primary Palmar Hyperhidrosis
| العنوان: | CT-guided Thoracic Sympathicolysis versus VATS Sympathectomy in the Therapeutic Concept for Severe Primary Palmar Hyperhidrosis |
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| المؤلفون: | Marc Olaf Liedke, JR Andresen, Aria Sallakhi, Fabian Scheer, Eric Schlöricke, Reimer Andresen |
| المصدر: | The Thoracic and Cardiovascular Surgeon. 70:152-158 |
| بيانات النشر: | Georg Thieme Verlag KG, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Pulmonary and Respiratory Medicine, Miosis, medicine.medical_specialty, Side effect, medicine.medical_treatment, 030218 nuclear medicine & medical imaging, 030207 dermatology & venereal diseases, 03 medical and health sciences, Sympathicolysis, 0302 clinical medicine, Ptosis, Humans, Hyperhidrosis, Medicine, Intubation, Thoracotomy, Sympathectomy, Retrospective Studies, Thoracic Surgery, Video-Assisted, business.industry, Sympathetic trunk, Surgery, Treatment Outcome, Quality of Life, medicine.symptom, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Background The objective was to compare computed tomography (CT)-guided thoracic sympathicolysis (CTSy) and video-assisted thoracoscopic sympathectomy (VATS) with regard to their feasibility, the occurrence of minor and major complications, and the clinical outcome. Materials and Methods In this study, 88 patients treated by CTSy and 86 patients treated by VATS were retrospectively included. CTSy was performed after establishing the entry plane below the level of the intervertebral space T2/3 via a dorsolateral approach using a 22-G coaxial needle. On average of 5 mL of a sympathicolytic mixture was instilled. VATS was performed under intubation anesthesia. After insertion of the instruments via a minithoracotomy, the parietal pleura was dissected and the sympathetic trunk severed below T2. The interventions were performed unilaterally, the contralateral side being treated after approximately 6 weeks. All patients evaluated their sense of discomfort before treatment as well as 2 days, 6, and 12 months after, on the basis of a Dermatology Quality of Life Index and additionally the side effects that occurred. Results Both treatments led to a marked reduction of symptoms, whereby mild recurrent sweating occurred over the further course, significantly higher in the CTSy patient group. Short-term miosis and ptosis were rarely found in both groups. As the most common side effect, transient compensatory sweating was reported by 16/88 patients after CTSy and 10/86 patients after VATS. Pneumothoraces developed postoperatively in 7/86 cases. Temporary pain after thoracotomy was experienced by 12/86 patients. Conclusion For patients with palmar hyperhidrosis, CTSy and VATS represented a minimally invasive treatment option that provided a high and largely equivalent level of benefit. |
| تدمد: | 1439-1902 0171-6425 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::23d8e8d34b36d36f27ad72711717dfb3Test https://doi.org/10.1055/s-0041-1725205Test |
| رقم الانضمام: | edsair.doi.dedup.....23d8e8d34b36d36f27ad72711717dfb3 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14391902 01716425 |
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