Surgery
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Most surgeons still perform T2 or T2-3 sympathectomy for palmar hyperhidrosis (PH), but both of these treatments can cause severe side effects. Some recent articles advocating T4 sympathectomy have obtained satisfactory results. The aim of this study was to compare the outcomes of 3 different levels of sympathectomy. ⋯ About 40% of ETS2 groups and 25% of ETS3 group patients were unsatisfied with their operation. All patients of the ETS4 group were satisfied with the outcome. In conclusion, ETS4 sympathectomy is an effective method for treating PH and it decreases the rate of compensatory hydrosis (CH).
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Bilateral thoracoscopic splanchnicectomy is a minimally invasive method of treating pain in patients with chronic pancreatitis. It offers good, short-term pain relief, but long-term success is difficult to predict. We analyze long-term results and identify factors predicting success of splanchnicectomy. ⋯ Splanchnicectomy offers prolonged (>4 years) benefit in 1 of 4 patients with severe chronic pancreatitis pain. Prior opioid use may adversely impact pain relief after splanchnicectomy.