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A Journal on Surgery

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Chirurgia 2002 February;15(1):21-4

language: English

Endoscopic transthoracic sympathectomy in the treatment of upper extremities hyperhidrosis. Anaesthetic implications

Zappi L., Carrossino D., Mignone L., Villani L., Filippi F., Bassetti C., Calandri P.


Background. Primary or cryptogenic hyperhidrosis is characterized by an overwhelming sweating, far exceeding what is normally requested by the physiologic thermal regulation. Transthoracic endoscopic sympathectomy (TES) has been established as the least invasive technique with a high success rate for the treatment of palmar and axillary hyperhidrosis.
Methods. The surgical procedure includes the treatment of both sides in a one-stage operation. As regards the anaesthetic technique and the management of perioperative problems, patients were monitored for arterial blood pressure, heart rate, ECG, pulse oximetry (SpO2), end-tidal carbon dioxide concentration, and peak inspired airway pressure. General anaesthesia by means of a double-lumen endobronchial tube was performed in order to enable the lungs to be collapsed alternately, thereby ensuring an easy and clear access to the sympathetic chain.
Results. The authors report the results of a 5-year experience on 250 patients who underwent transaxillary dorsal sympathectomy.
Conclusions. A new minimally invasive approach is described, that is performed by a single-entry specifically modified thoracoscope which does not require carbon dioxide insufflation of the pleural cavity.

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