Clipping of T2 sympathetic chian block for essential hyperhidrosis

초록

Background : A definitive cure for essential hyperhidrosis can be obtained by upper thoracic sympathectomy. However, this is offset by the occurrence of compensatory hyperhidrosis as a side effects and it is irreversible. We performed thoracoscopic sympathetic chain block using endoscopic clip in order to avoid compensatory hyperhidrosis. Material & Method : From Aug. 1998 to Nov. 1998, 42 cases of thoracoscopic clipping of T2 sympathetic chain were performed. The sympathetic chain was clipped instead of cutting using endoscopic clip. Result: Bilateral procedure took less than 40 minutes and occasionally necessitated one night in the hospital. There were no mortality nor life-threatening complications. Horner’s syndrome occurred in two cases. At the end of postoperative follow-up (median 3 months), 95.0% of the patients were satisfied with the results. Compensatory sweating occurred in 31 cases (77.5%) where nine of those cases were classified as either embarrassing( 6 cases -15.0%) or disabling( 3 cases-7.5%). Conclusion : Endoscopic thoracic T2 sympathetic chain block using endoscopic clipping is an efficient, safe and minimally invasive surgical method for the treatment of palmar and craniofacial hyperhidrosis and the results were similar to those underwent T2 sympathicotomy.