-realizan et en 123 pacientes entre edades de 9 a 71 aos
-realizan ets para tratar de aliviar la isquemia palmar en 5 pacientes
- al 55% de los operados les resulto problematico el sc, el 10% lo encontro insufrible
-dicen que la mejor tecnica de operar es con endoscopio equipado con laser quemador, en vez de cortar o clipear los ganglios T

http://www.ncbi.nlm.nih.gov/pubmed/18325216?ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

1: Ann R Coll Surg Engl. 2008 Mar;90(2):142-5.Links
Thorascopic sympathectomy performed using laser.Black SA, Taylor FG, Russell MH, Ariga R, Thomas MH.
Department of Vascular Surgery, St Peter's Hospital, Chertsey, Surrey, UK.

INTRODUCTION: Thorascopic sympathectomy is accepted as an effective treatment for palmar hyperhidrosis, facial blushing and to a lesser extent for digital ischaemia and axillary hyperhidrosis. PATIENTS AND METHODS: Data were collected retrospectively on patients undergoing thorascopic sympathectomy at St Peter's Hospital between 1987 and 2006. Patients were followed up by telephone interview. RESULTS: A total of 233 thorascopic sympathectomy procedures were performed by a single operator in 123 patients. Ages ranged from 9-71 years and 75 were women. In patients, 105 had a bilateral and 13 a unilateral procedure, 5 patients had a bilateral procedure performed in two stages. In 6 upper limbs, the procedure could not be done. Overall, 110 patients (90%) had the procedure performed for palmar hyperhidrosis, 8 (6%) for facial blushing and in 5 (4%) patients the operation was performed for digital ischaemia with tissue loss. There were no deaths and all patients were discharged on day 1 following the procedure. Complications included bleeding (2), pulmonary oedema (1) and failed procedure (2); however, no incidences of Horner's syndrome occurred. Only 40 of 123 (32.5%) patients gave follow-up information. Of this small group, 33 of 40 (83%) were cured, 4 of 40 (10%) were better, 2 of 40 (5%) were unchanged and 1 patient was worse. Only 22 out of 40 (55%) of these patients were troubled by compensatory sweating, with only 4 of 40 (10%) reporting this as a major problem. CONCLUSIONS: Thorascopic sympathectomy is safe and can be carried out as a single bilateral procedure in the majority of cases. The laser allows the use of a single port, requires less dissection than surgical or clipping techniques, is more precise than diathermy and may be less likely to cause a Horner's syndrome.

PMID: 18325216 [PubMed - in process]
