Videotorakoskopická horní hrudní sympatektomie- chirurgická alternativa léčby lokalizované hyperhidrózy

Videothoracoscopic Upper Thoracic Sympathectomy - Alternative SurgicalTreatment of Localized Hyperhidrosis

Hyperhidrosis, local or generalized, is an unpleasant disease which causes the affected subjectsserious psychosocial problems. Secondary hyperhidrosis is an associated symptom of various pathologicalconditions. In the submitted paper the authors analyze above all the primary idiopathic formthe most probable cause of which is vegetative disbalance. At present in treatment conservative localprocedures predominate such as various ointments, powders and more recently iontophoresis orintradermal administration of botulotoxin A which, however, do not always produce the desirableeffect. The authors submit their experience with the surgical alternative of treatment of palmar andaxillary hyperhidrosis, i.e. videothoracoscopic upper thoracic sympathectomy. On account of thelocal form of the disease they implemented four bilateral operations with an excellent effect, anotherfour patients were operated on account of vascular affections of the upper extremities.The authors discuss in detail the indications for and technique of operation, risk and side-effectsand above all results based on reports in the literature at home and abroad. From the discussion andexperience ensues that upper thoracic sympathectomy can be recommended as a suitable surgicalalternative of treatment of severe forms of local hyperhidrosis of the upper extremities and face inparticular because of the immediate results, minimal morbidity and long-term effect. The articleshould make the wider medical and lay public familiar with this not very widely used method.

Key words:
palmar hyperhidrosis - axillary hyperhidrosis - videothoracoscopy - upper thoracicsympathectomy