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Sympathectomy

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https://www.readbyqxmd.com/read/28645243/extended-periarterial-sympathectomy-evaluation-of-long-term-outcomes
#1
Collier S Pace, Wyndell H Merritt
BACKGROUND: Periarterial sympathectomy is a proposed surgical treatment for patients with refractory Raynaud syndrome; however, there is debate regarding the indications and extent of dissection. Due to the segmental arterial sympathetic innervation, we favor an extended sympathectomy in concert with vein graft reconstruction of occluded vessels when necessary. The purpose of this study is to examine outcomes of extended periarterial sympathectomy in our patients. METHODS: A retrospective chart review was performed on 46 patients who underwent 58 periarterial sympathectomies (12 bilateral) since 1981...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28594814/-deliberations-on-lumbar-sympathectomy-years-and-practice-on-the-occasion-of-the-90th-anniversary-of-using-the-method-in-russia
#2
E P Kokhan, O V Pinchuk
The article deals with the literature data on history of and modern attitude to lumbar sympathectomy in treatment for occlusive lesions of lower-limb peripheral arteries. This is followed by analysing the experience of 1,764 operations both independent and those combined with vascular reconstructions over more than a 45-year period. A conclusion is drawn that lumbar sympathectomy remains an operation associated with minimal traumaticity and a low complication rate, thus for long years improving the quality of life and destiny of patients...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28590211/a-systematic-review-of-the-effectiveness-of-palliative-interventions-to-treat-rectal-tenesmus-in-cancer
#3
Áine Ní Laoire, Lucy Fettes, Fliss Em Murtagh
BACKGROUND: Rectal tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of tenesmus in this patient population. AIM: To identify and examine the effectiveness of interventions to palliate rectal tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options. DESIGN: A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance...
March 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28527965/perfusion-index-an-indicator-of-success-during-endoscopic-thoracic-sympathectomy-for-hyperhidrosis
#4
Eric I-Hun Jeng, Nikolaus Gravenstein, Charles T Klodell
BACKGROUND: Endoscopic thoracic sympathectomy (ETS) is indicated for refractory hyperhidrosis. The pulse oximetry-derived perfusion index (PI) quantifies pulsatile blood flow at the oximeter. Thoracic sympathectomy increases blood flow; thus we postulate it will reliably increase PI. We evaluated the ipsilateral finger PI as a predictor of successful sympathectomy during ETS. METHODS: After institutional review board approval and informed consent, 100 adult patients undergoing bilateral ETS were studied...
May 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28446983/thoracic-sympathectomy-for-hyperhidrosis-from-surgical-indications-to-clinical-results
#5
REVIEW
Fernando Vannucci, José Augusto Araújo
Sympathectomy and its variations have been performed in thoracic surgery for more than 100 years. However, its indications have undergone profound modifications in this period. Likewise, since then the surgical technique has also evolved dramatically up to the minimally invasive techniques worldwide accessible in present days. Currently, primary hyperhidrosis is, by far, the main indication for thoracic sympathectomy and this procedure is usually carried out thoracoscopically with excellent results. However, until today, hyperhidrosis is a part of thoracic surgery still surrounded by controversy, persisting as an open field over which some confusion still resides regarding its pathophysiology, terms definitions and operative approaches...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28431730/a-new-device-of-needlescopic-thoracic-sympathectomy-through-a-skin-incision
#6
Hidehiro Yamamoto, Masayoshi Okada
We describe a new technique of performing sympathectomy with a new device. A single skin incision 3 mm long was made in the armpit. The device enables complete resection of the sympathetic segment through a single skin incision, whereas sympathectomy is limited by the use of the conventional needle technique. Even if sympathetic nerves and blood vessels were overlapping, separation of the two organs was performed safely. This device increases the possibility of planning surgical procedures for patients with difficult anatomies...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28422886/comparison-of-t2-and-t3-sympathectomy-for-compensatory-sweating-on-palmar-hyperhidrosis
#7
RANDOMIZED CONTROLLED TRIAL
Atila Turkyilmaz, Sami Karapolat, Kubra Nur Seyis, Celal Tekinbas
BACKGROUND: An otherwise successfully performed endoscopic thoracic sympathectomy (ETS) to treat palmar hyperhidrosis (PH) often has a serious side effect: compensatory sweating (CS). This side effect occurs in other parts of the body to a disturbing extent. The objective of this study is to determine whether there is a relationship between the level of ETS performed on patients with PH, and the occurrence and severity of postoperational CS. METHODS: Between January 2014 and January 2015, ETS procedures were performed on 25 randomly selected consecutive subjects (group A) at T2 level, and on another 25 subjects (group B) at T3 level, who all felt severely handicapped due to PH...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28395387/novel-techniques-and-approaches-to-minimally-invasive-thoracic-surgery
#8
Osita Onugha, Rasheed Ivey, Robert McKenna
Approximately two decades ago, thoracic surgery witnessed the leap from thoracotomy to the first video-assisted thoracic surgery (VATS) lobectomy. Minimally invasive lobectomy and hilar lymphadenectomy is now widely established as a safe and oncological sound technique that is the standard of care for early-stage lung cancer. The move toward less invasive surgery has no doubt driven the innovation of sophisticated instruments and technology to cope with the demanding need of working through a restricted incision...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28389800/optimal-targeting-of-sympathetic-chain-levels-for-treatment-of-palmar-hyperhidrosis-an-updated-systematic-review
#9
Hai-Wei Sang, Guo-Liang Li, Peng Xiong, Ming-Chuang Zhu, Min Zhu
BACKGROUND: Palmar hyperhidrosis involves excessive sweating of the palms, with no known etiology. Endoscopic thoracic sympathectomy (ETS) is a safe and effective treatment for palmar hyperhidrosis, but compensatory hyperhidrosis is a common complication after ETS, leading to reduced patient satisfaction and postoperative quality of life. However, the appropriate level of the sympathetic chain to target with ETS to achieve maximum efficacy and reduce the risk of compensatory hyperhidrosis (CH) is controversial...
April 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28367972/a-brain-sparing-diphtheria-toxin-for-chemical-genetic-ablation-of-peripheral-cell-lineages
#10
Mafalda M A Pereira, Inês Mahú, Elsa Seixas, Noelia Martinéz-Sánchez, Nadiya Kubasova, Roksana M Pirzgalska, Paul Cohen, Marcelo O Dietrich, Miguel López, Gonçalo J L Bernardes, Ana I Domingos
Conditional expression of diphtheria toxin receptor (DTR) is widely used for tissue-specific ablation of cells. However, diphtheria toxin (DT) crosses the blood-brain barrier, which limits its utility for ablating peripheral cells using Cre drivers that are also expressed in the central nervous system (CNS). Here we report the development of a brain-sparing DT, termed BRAINSPAReDT, for tissue-specific genetic ablation of cells outside the CNS. We prevent blood-brain barrier passage of DT through PEGylation, which polarizes the molecule and increases its size...
April 3, 2017: Nature Communications
https://www.readbyqxmd.com/read/28318666/temporary-removal-cardiac-sympathetic-denervation-100-years-later-jonnesco-would-have-never-believed-it
#11
Peter J Schwartz, Gaetano M De Ferrari, Luigi Pugliese
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
March 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28316628/idiopathic-harlequin-syndrome-manifesting-during-exercise-a-case-report-and-review-of-the-literature
#12
Hussein Algahtani, Bader Shirah, Raghad Algahtani, Abdulah Alkahtani
Harlequin syndrome is a rare autonomic disorder characterized by unilateral facial flushing and sweating with contralateral anhidrosis induced by exercise, heat, and emotion. It is usually idiopathic but could be the first manifestation of several serious underlying medical conditions. Medical or surgical treatments are not required for idiopathic Harlequin syndrome, but social and psychological factors may indicate sympathectomy or botulinum toxin injection. In this article, we report a case of idiopathic Harlequin syndrome and review the literature...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28314473/complex-regional-pain-syndrome-in-burn-pathological-scarring-a-case-report-and-review-of-the-literature
#13
Suman Mewa Kinoo, Bhugwan Singh
Chronic pain in burn pathological scarring is not an uncommon occurrence. The mechanisms of pain are not clearly understood and hence the management approach is often a daunting task. However, meticulous physical examination of these patients may classify them as complex regional pain syndrome, type I. We present a patient with classic signs and symptoms of complex regional pain syndrome associated with burn pathological scarring of her left forearm that had a favourable response to a thoracoscopic sympathectomy...
March 14, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28303689/non-healing-ischaemic-digital-ulcer-in-a-systemic-sclerosis-patient-a-challenging-clinical-case
#14
Sophie Blaise, Matthieu Roustit, Alexandra Forli, Bernard Imbert, Jean-Luc Cracowski
Ischaemic digital ulcers (DUs) are an indicator of the severity of the microangiopathy in patients with systemic sclerosis (SSc). DUs are a frequent complication, affecting about 50% of patients with SSc, and are often recurrent. In cross-sectional studies involving patients with SSc, the frequency of ischaemic DUs was 12-16% with a major impact on hand function and quality of life. Effective therapy for DUs remains elusive. Intravenous iloprost has been demonstrated to have a positive effect on healing of active DUs...
March 16, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28297053/general-regional-or-local-anesthesia-for-successful-radial-cephalic-arteriovenous-fistula
#15
David Shemesh, Yefim Raikhinstein, Ilya Goldin, Oded Olsha
Autogenous fistulas and in particular radiocephalic fistulas are recommended as the first vascular access for hemodialysis. Unfortunately, the rates of early failure and non-maturation are very high. For more than a decade, brachial plexus block has been proposed as the anesthesia of choice for fistula creation due to its beneficial sympathectomy-like effect, causing vasodilation and attenuation of spasm. Until recently, there was not a single randomized clinical study supporting this proposition. Because performing regional anesthesia is time-consuming and requires expertise, many surgeons prefer local or general anesthesia for vascular access surgery...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28284421/microwave-treatment-for-axillary-hyperhidrosis-and-bromhidrosis
#16
I Sánchez-Carpintero, A Martín-Gorgojo, R Ruiz-Rodríguez
Axillary hyperhidrosis (AH) and bromhidrosis are common causes of consultation in dermatology. Currently, the most widely prescribed treatment for AH is botulinum toxin, a very effective but temporary option; it is totally ineffective in bromhidrosis. Sympathectomy is an increasingly infrequent choice of treatment due to the high incidence of compensatory hyperhidrosis. We describe the treatment of AH and bromhidrosis with a novel microwave device that can fibrose eccrine and apocrine glands, achieving possibly permanent results...
June 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/28282662/r3-versus-r4-thoracoscopic-sympathectomy-for-severe-palmar-hyperhidrosis
#17
Wenxiong Zhang, Yiping Wei, Han Jiang, Jianjun Xu, Dongliang Yu
Background Thoracoscopic sympathectomy (TS) was the preferred surgical treatment for palmar hyperhidrosis (PH), but postoperative complications such as compensatory sweating (CS) were common. This study was projected to compare R3 versus R4 TS for treating severe PH. Methods From April 2009 and March 2015, 106 consecutive patients with severe PH underwent bilateral R3 (n = 62) or R4 (n = 44) TS at The Second Affiliated Hospital of Nanchang University. The patients were followed up to evaluate symptom resolution, postoperative complications, satisfaction level, and severity of CS...
March 10, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28282661/influence-of-body-mass-index-on-compensatory-sweating-in-patients-after-thoracic-sympathectomy-due-to-palmar-hyperhidrosis
#18
Lukasz Dobosz, Natalia Cwalina, Tomasz Stefaniak
Background Thoracic sympathectomy (TS) is one of the most effective methods of treatment of primary hyperhidrosis. One of the side effects of this procedure is compensatory sweating (CS). Objective The aim of our study was to evaluate the influence of body mass index (BMI) on CS in patients after TS due to palmar hyperhidrosis. Methods Data from 157 patients with palmar hyperhidrosis who underwent TS were collected. The patients were subsequently divided in two groups according to their initial BMI: group A, BMI < 25 kg/m(2), and group B, BMI ≥ 25 kg/m(2)...
March 10, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28273934/a-systematic-review-and-meta-analysis-of-t2-t3-or-t4-to-evaluate-the-best-denervation-level-for-palmar-hyperhidrosis
#19
Wenxiong Zhang, Dongliang Yu, Yiping Wei, Jianjun Xu, Xiaoqiang Zhang
We systematically reviewed and compared the clinical outcomes of thoracoscopic sympathectomy (TS) at different denervation levels for palmar hyperhidrosis. We searched PubMed, Ovid MEDLINE, EMBASE, Web of Science, ScienceDirect, the Cochrane Library, Scopus and Google Scholar for relevant studies published during 1990-2016. Symptom resolution, patient satisfaction, compensatory sweating (CS), recurrence, dry hands and gustatory sweating were assessed. We selected 13 studies from 2228 for the final analysis...
December 2017: Scientific Reports
https://www.readbyqxmd.com/read/28273218/comparison-between-high-and-low-levels-thoracic-sympathectomy-for-the-treatment-of-palmar-and-axillary-primary-hyperhidrosis-systematic-review-and-meta-analysis
#20
Gilmar Felisberto Júnior, Cláudio José Rubira, João Paulo Sanches Berumudes, Salum Bueno DA-Silveira-Júnior
Primary hyperhidrosis (PH) is a condition that has a great impact on affected individuals' quality of life, regardless of its location. Its surgical treatment is done through thoracic sympathectomy performed by videothoracoscopy. Standardization of the technique includes section of the sympathetic trunk at different levels, according to the site of symptoms. The aim of this review is to evaluate the efficacy of thoracic sympathectomy through a systematic literature review comparing sympathectomy at different levels of the sympathetic chain...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
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