Objective:
The aim of this study was to evaluate and report perioperative clinical experience in patients undergoing bilateral sympathectomy with video-assisted thoracoscopic approach for the management of hyperhidrosis.
Material and Methods:
After the approval of the ethics committee all patients undergoing bilateral video-assisted thoracoscopic sympathectomy for the management of hyperhidrosis between 01/01/2007-01/07/2010 were included in the study. Associated data were obtained from patient files and anaesthesia records.
Results:
Mean age of thirty-five patients operated with bilateral video-assisted thoracoscopic sympathectomy for the management of hyperhidrosis was 25.1±5.9 years, and 22 of them were female. All patients were intubated with double-lumen endotracheal tube and managed with one-lung ventilation. In the early postoperative period, after extubation, two of three patients who were diagnosed with pneumothorax were treated with percutaneous approach. The last patient who was a heavy-smoker and persistently demonstrated low oxygen saturation values despite bronchodilator therapy required thorax drainage tube. Three patients diagnosed as pneumothorax with chest x-ray examination recovered spontaneously. During the first 24 hours, all patients’ pain scores remained less than 3 according to verbal analogue scale. After a week, 80 % of the patients had pain scores of < 3. The patients (n=7) whose pain scores were more than three were those who had clipping during sympathectomy.
Conclusion:
Although this kind of surgery was performed on low-risk patients and its known superiorities over open thoracotomy, VATS requires a particular ventilation management during intraoperative period and very close monitoring of postoperative complications and effective postoperative analgesia. Therefore, in planning anaesthesia, indications of thoracic surgery, and patients’ characteristics should be evaluated in the same context.
Keywords: Video-Assisted Thoracoscopic Surgery, sympathectomy, single-lung ventilation