Nonintubated Transareolar Endoscopic Thoracic Sympathectomy with a Flexible Endoscope: Experience of 58 Cases

• DOI: 10.5761/atcs.oa.15-00241
• Publication Date: 2015-09-28T18:03:05Z
• Authors: Jianfeng Chen; Jianbo Lin; Yuanrong Tu; Min Lin; Xu Li; Fancai Lai
• Keywords: Endoscope; Sore throat; Thoracic cavity; Cardiothoracic surgery; Endotracheal intubation

Natural orifice transluminal endoscopic surgery (NOTES) has recently become a hot spot in the field of minimally invasive surgery. But, most procedures are still early stages development and limited to animal experiments. Transareolar could work as viable intermediate step before thoracic NOTES. Under intravenous anesthesia without endotracheal intubation, transareolar sympathectomy (ETS) with flexible endoscope rarely been attempted. The objective this study is evaluate feasibility safety novel technique managing primary palmar hyperhidrosis (PPH).From June 2012 July 2014, total 58 male patients severe PPH underwent ETS by use endoscope. was introduced through incision on edge areola into cavity. sympathetic chain ablated at level fourth rib.All were successfully performed mean operating time 33.6 ± 8.3 min. All regained consciousness rapidly none them complained about sore throat after There no operative mortality conversion open procedure. symptoms all disappeared soon cut off. Fifty six (96.6%) discharged from hospital first postoperative day. complications minor, developed Horner's syndrome. At 3 months postoperatively, there obvious surgical scar chest wall, pain. Compensatory (CH) appeared 19 patients. No recurrent observed our study. One year follow-up revealed an excellent cosmetic result degree satisfaction.Nonintubated safe, effective therapeutic procedure, which possible advantages NOTES can be routine clinical practice for