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CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 1998 June;39(3):387-9

language: English

Com­puted tomog­raphy ­guided tho­racic sym­pa­thol­ysis for ­palmar hyper­hid­rosis

Lucas A., Rolland Y.*, Journeaux N., Kerdiles Y.*, Chevrant-Breton J.**, Duvauferrier R.*

From the Vas­cular Sur­gical Depart­ment, * ­Radiology Depart­ment Hôpital Sud
** Der­ma­tology Depart­ment Hôpital Pont­chaillou C.H.R.U. de ­Rennes, ­France


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Methods. Six­teen ­patients (­mean age 26.3 ­years; ­range 18-38) ­with ­palmar hyper­hid­rosis under­went 29 sym­pa­thol­yses ­after unsuc­cessful med­ical, and in 8 ion­o­phor­esis, treat­ments. Sym­pa­thol­ysis was per­formed ­under ­local anes­thesia ­with com­puted tom­o­graphic guid­ance. ­After opac­ifi­ca­tion of the injec­tion ­site at T3 ­with Iopam­iron 200, phe­nol­iza­tion was per­formed ­with 10 ml 6% ­phenol.
­Results. ­Good imme­diate ­results eval­u­ated on the ­basis of ­venous dil­a­ta­tion, and dry­ness and ­warmth of the ­skin ­were ­obtained in 23 ­cases (80%). ­There ­were 6 imme­di­ately unsuc­cessful pro­ce­dures in 4 ­patients. At 20 ­months, ­good ­results, ­assessed on the ­basis of objec­tive cri­teria and sub­jec­tive ­patient ­self-eval­u­a­tion ­were ­obtained in 22 ­cases (75% ­including imme­diate fail­ures). Com­puted tomog­raphy ­guided tho­racic sym­pa­thol­ysis per­formed ­under ­local anes­thesia is an effec­tive treat­ment for ­palmar hyper­hid­rosis. Mor­bidity is low and hos­pital ­stay is ­short.
Con­clu­sions. Our find­ings sug­gest ­that tho­racic sym­pa­thol­ysis ­should be indi­cated as the ­first inten­tion pro­ce­dure ­when sur­gery is ­required in ­patients ­with ­palmar hyper­hid­rosis.

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