Non-Intubated Bilateral Single PortEndoscopic Thoracic Sympathectomy

Özet

Objective: Primary focal hyperhidrosis is excessive sweating required for body thermoreg-ulation. The most commonly affected sites are the palms and axillae. It is a benign disease, but one which has physical, physiological, and social effects, especially for adults. The best treatment is a thoracic sympathectomy, which may be performed using different approaches. Thoracoscopy is generally performed with a 5-mm thoracoscope and double lumen intuba-tion. The aim of this study was to report experience with this technique using laryngeal mask ventilation, which is less invasive and shortens the operative time.Methods: In all, 35 patients with palmar or axillar hyperhidrosis underwent a nonintubated endoscopic thoracic sympathectomy between January 2016 and August 2017. All of the patients were placed in a semi-Fowler position after the application of the laryngeal mask.Results: The operative time, the expansion of the lung as seen on a postoperative chest X-ray, and the postoperative pain score were recorded. The operative time was calculated from the first incision until the closure of the skin suture. The median length of the oper-ation was 21±3 minutes. There were no complications seen in the first postoperative 24 hours and all of the patients were discharged after 1 day of hospitalization.Conclusion: A nonintubated thoracoscopic sympathectomy procedure is a less invasive method that uses laryngeal mask, and which also reduces the operative time. As a result of bilateral ventilation, this procedure is highly effective at avoiding postoperative pneumoth-orax.