Clinical autonomic research : official journal of the Clinical Autonomic Research Society
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Comparative Study
Comparative analysis of T3 selective division of rami communicantes (ramicotomy) to T3 sympathetic clipping in treatment of palmar hyperhidrosis.
Compensatory sweating is a major complaint following endoscopic thoracic sympathetic surgery in treatment of palmar hyperhidrosis. T3 ramicotomy was applied in order to decrease compensatory sweating. From Oct 1999 to June 2002, forty patients underwent T3 sympathetic clipping (group I), and 68 patients underwent T3 ramicotomy (group II) to treat palmar hyperhidrosis. ⋯ The rate of satisfaction was 82.5 % (33/40) in group I and 67.6 % (46/68) in group II with no significant statistic difference (p = 0.067). Excluding patients with persistent sweating postoperatively, the rate of compensatory sweating in group II was 67.4%, which was significantly lower than in group I 94.1%, with a p value of 0.003. Although the rate of persisting sweating after operation was high, T3 ramicotomy resulted in lower rate of compensatory sweating compared to T3 sympathetic clipping.
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Complex regional pain syndrome (CRPS) is a neurological syndrome that usually affects one or more extremities, and can cause chronic pain and permanent deformities. This study aimed to analyze the efficacy of endoscopic thoracic sympathicotomy (ETS) in the treatment of pain in patients with CRPS stage II and III operated on in our clinic. Seven patients (four males and three females; mean age 34.7 years; American Society of Anesthesiologists physical status 1 and 3; post-operative follow-up from 5 to 49, mean 33.6 months), with diagnoses of CRPS type I and II, stages II and III, were operated on as outpatients. ⋯ Analgesics were no longer needed after surgery. All patients had their quality of life improved. According to the present investigation, ETS, as described, was efficient for the relief of pain and improvement of the quality of life in patients with CRPS stage II and III.