RESUMO
BACKGROUND: Video-endoscopic sympathectomy is the current treatment of choice for severe primary hyperhidrosis. Because of the possible postsurgical side effects, the procedure is carried out using removable endoclips that block sympathetic nerve transmission. This study describes the short and "midterm" side effects and complications of this method for the treatment of palmar, axillary, and facial hyperhidrosis. MATERIALS AND METHODS: Two hundred and ninety-four sympathectomies were carried out between September 2003 and June 2006 and followed-up after 17 months. Patients with isolated facial hyperhidrosis were clamped at the T2-3 level clamping. Patients with isolated axillary hyperhidrosis were clamped at the T3-4 level. RESULTS: All patients with palmar and palmar-axillary hyperhidrosis were completely satisfied after clamping at the third thoracic ganglion (T3) level. Immediate complete recovery was achieved in 98% of patients postsurgery. Major complications were Horner's syndrome (1%) and pneumothorax (3%). Compensatory sweating occurred in 22%. No cases of gustatory sweating were reported. All patients were "satisfied" with their results and no patients requested removal of the clips. INTERPRETATION: Thoracoscopic sympathecotomy clamping is a successful treatment for hyperhidrosis. Local hyperhydrosis does not reoccur after 17 months, but there is some degree of compensatory hyperhidrosis.
Assuntos
Bloqueio Nervoso Autônomo , Hiperidrose/complicações , Hiperidrose/cirurgia , Simpatectomia , Adolescente , Adulto , Constrição , Feminino , Humanos , Hiperidrose/terapia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Simpatectomia/efeitos adversos , Resultado do TratamentoRESUMO
We describe the case of a 73-year-old man, with a history of previous coronary artery by-pass, who presented at our division for new onset of angina, hypotension and dyspnea due to a primary giant para-cardiac lipoma. The success of complete resection of the mass achieved by means of video-assisted thoracic surgical procedure demonstrated the efficacy and safeness of this method in the treatment of benign cardiac tumours.