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Complications after bilateral thoracoscopic sympathicotomy for primary focal hyperhidrosis

Introduction

Primary focal hyperhidrosis is a functional disorder of an excessive sweating that can significantly deteriorate the person’s every day quality of life. It is estimated that there is about 2.8% of world population affected with this unpleasant condition, especially among young people. Bilateral thoracoscopic sympathicotomy is nowadays well established one-day minimal invasive surgical procedure, with very good postoperative results and the opportunity for the patients to be capable for their everyday life and working, a day after the operation, with adequate analgetics if necessary. However, the complications after bilateral thoracoscopic sympathicotomy can seriously worsen their quality of life, beyond this functional disorder of an excessive perspiration.

The aim of this study is to evaluate the postoperative complications after bilateral thoracoscopic sympathicotomy and their influence on person’s quality of life.

Key words: primary focal hiperhidrosis, bilateral thoracoscopic sympathectomy, minimal invasive surgery, complications

Material and methods

This study included 1400 persons with estimated severe primary focal hyperhidrosis, mean age of 29.68±7.6 years, who underwent bilateral thoracoscopic sympathicotomy at the Clinic for the thoracic surgery, Institute for the pulmonary diseases of Vojvodina, Sremska Kamenica, Serbia, between 2008 and 2015. In all the patients bilateral thoracoscopic sympathicotomy has been performed by using electric or harmonic scalpel. Complications have been divided as intraoperative and postoperative complications.

Results

In all the patients, the operation has been performed successfully on the both sides. There were no mortality and serious complications which demand prolong postoperative hospitalisation. In 3 patients (0,28%) the conversion to minithoracotomy had been performed due to bleeding from intercostal vein, 11 patients (0,78%) had pleural adhesions with prolong air leak after adhesiolysis. After the operation 22 patients (1,57%) had pneumothorax that has been solved by chest tube, one patient (0,07%) had postoperative haematothorax solved by re-VATS. There were two patients with severe complications that affected their quality of life. One patient (0,07%) with Horner syndrome, and one patient (0,07%) with Horner syndrome and plexus brachialis paresis on left arm.

Conclusion

Bilateral thoracoscopic sympathicotomy is minimal invasive surgical procedure that can be performed with low rate of complication, but some of them can significantly deteriorate the person’s quality of life

Ivan Kuhajda, Miroslav Ilić
Clinic for thoracic surgery, Institute for pulmonary diseases of Vojvodina, Sremska Kamenica, Serbia

Corresponding author's contact:
Phone +381 63 837 80 47
e mail: kuhajda@gmail.com
fax: +381 21 527 960

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