BIBLIOGRAFIA SELECCIONADA/RELACIONADA
http://www.tecnovasc.com/esp/servicios-tecnovasc/bibliografia/bibliogr_4.html
HIPERHIDROSIS
Video-assisted thoracoscopic "resympathicotomy" for palmar hyperhidrosis: analysis of 42 cases.
Ann Thorac Surg 2001;72:895-8.
Lin T-S
Division of General Thoracic Surgery, Changhua Christian Hospital, Chung Shan Medical and Dental College, Taichung, Taiwan. 
Background. There are rare reports of video-assisted thoracoscopic resympathicotomy for patients with palmar hyperhidrosis. I present our experience in treating a persistent or recurrent palmar hyperhidrosis after primary endoscopic sympathectomy or sympathicotomy and discuss the perioperative management. 
Methods. We reoperated on 42 patients using a technique of video-assisted thoracoscopic resympathicotomy. All patients were placed in a semi-sitting position under single- or double-lumen intubated anesthesia. An 8-mm, 0 thoracoscope was used to interrupt the nerve conduction to the palms from the T2 and T3 ganglia, through one or two 0.8-cm subaxillary incisions. 
Results. The reasons for failure of endoscopic sympathectomy or sympathicotomy in 26 patients included pleural adhesion (15 of 26, 57.7%), incorrect identification of T2 ganglion (3 of 26, 11.5%), vessel overriding or close to sympathetic nerve (3 of 26, 11.5%), incomplete interruption of sympathetic nerve (2 of 26, 7.7%), medially located sympathetic nerve (2 of 26, 7.7%), and aberrant venous arch (1 of 26, 3.8%). The causes of recurrent palmar hyperhidrosis after primary transthoracic endoscopic sympathicotomy or sympathectomy (TES) in 16 patients included a possible effect of T3 ganglion (8 of 16, 50%), Kuntz fiber (3 of 16, 18.8%), nerve regeneration (3 of 16, 18.8%), and incomplete interruption of T2 ganglion (2 of 16, 12.5%). Surgical complications included pneumothorax (1 patient, 2.4%), hemothorax (1 patient, 2.4%), and compensatory sweating (36 patients, 86%). All patients had obtained successful bilateral sympathectomies and had satisfactory results after a mean of 32.1 months of follow-up. 
Conclusions. Video-assisted thoracoscopic resympathicotomy is an effective and safe method for a previously unsuccessful sympathectomy or recurrent palmar hyperhidrosis if the surgeon acknowledges possible anatomic variations and can overcome the problems related to pleural adhesions. 
////////////////////////////
CIRUJANO QUIERE ENGAARTE POR SEGUNDA VEZ. 2OPERACION
 Este cirujano LIN ha visto la mina de oro y va a por ella como sea. Encima estos cirujanos tienen la CARA de hacer estos estudios con toda la pompa del mundo para que parezcan creibles. Como este cirujano tiene un huevo de pacientes con hh operados y cabreados por el estropicio que les han hecho (aunque les haya cobrado 6000 euros), pues dice "pues voy a sacar mas tajada, les voy a cobrar otra vez" me invento la re-operacion (reversal) y asi hasta que me de la gana.
http://www.tecnovasc.com/esp/servicios-tecnovasc/bibliografia/bibliogr_4.html