Practical dermatology
Usefulness of Bilateral Sympathectomy Using Video-Assisted Thorascopic Surgery in the Treatment of Essential Hyperhidrosis
Utilidad de la Simpatectomía Videotoracoscópica Bilateral en el Tratamiento de la Hiperhidrosis Esencial
C.E. García Francoa,
, A. Españab
Autor para correspondencia
cegarciaf@unav.es
Correspondence: Departamento de Cirugía Torácica, Clínica Universitaria de Navarra, Avenida de Pío XII, 36, 31008 Pamplona, Spain.
Correspondence: Departamento de Cirugía Torácica, Clínica Universitaria de Navarra, Avenida de Pío XII, 36, 31008 Pamplona, Spain.
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"apellidos" => "García Franco" "email" => array:1 [ 0 => "cegarciaf@unav.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "España" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Cirugía Torácica, Clínica Universitaria de Navarra (CUN), Pamplona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Departamento de Dermatología, Clínica Universitaria de Navarra (CUN), Pamplona, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Departamento de Cirugía Torácica, Clínica Universitaria de Navarra, Avenida de Pío XII, 36, 31008 Pamplona, Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad de la Simpatectomía Videotoracoscópica Bilateral en el Tratamiento de la Hiperhidrosis Esencial" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec84250" "palabras" => array:8 [ 0 => "palmar" 1 => "plantar" 2 => "axillary" 3 => "craniofacial" 4 => "hyperhidrosis" 5 => "thoracic sympathetic chain" 6 => "botulinum toxin" 7 => "endoscopic thoracic sympathectomy" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84249" "palabras" => array:6 [ 0 => "hiperhidrosis palmar" 1 => "axilar" 2 => "plantar y/o cráneo-facial" 3 => "cadena simpática ganglionar torácica" 4 => "toxina botulínica" 5 => "simpatectomía torácica endoscópica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Essential, idiopathic, or primary hyperhidrosis is defined as excessive sweating in certain areas of the body due to factors unrelated to other disease. Clinical presentation can be categorized as palmar, plantar, axillary, or craniofacial. Medical treatment (aluminium salts, iontophoresis, anticholinergic drugs, and alfa-2-agonists) is of questionable effectiveness. Intradermal injections of botulinum toxin are very effective for the treatment of axillary hyperhidrosis. Surgical treatment involves resection (sympathectomy) or electrocautery (sympathicolysis) of the thoracic sympathetic chain, or compression of the sympathetic chain with clips, in all cases via video-assisted thorascopic surgery. One or more ganglia between T2 and T5 are usually resected depending on the area affected by hyperhidrosis: T2 for craniofacial hyperhidrosis, T3 and T4 for palmar hyperhidrosis, and T3 to T5 for combined palmar and axillary hyperhidrosis. The technique is very useful and is effective in those patients with primary hyperhidrosis who have not responded to conservative treatment.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Se define como hiperhidrosis esencial, idiopática o primaria la excesiva sudoración de determinadas áreas del cuerpo debido a una causa no asociada a otras patologías. Distinguimos 4 formas de presentación clínica: palmar, plantar, axilar y/o cráneo-facial. El tratamiento médico (sales de aluminio, iontoforesis, anticolinérgicos y alfa-2-agonistas) tiene una eficacia cuestionada. El tratamiento con inyecciones intradérmicas de toxina botulínica tiene una gran eficacia en el tratamiento de la hiperhidrosis axilar. El tratamiento quirúrgico consiste en la resección de la cadena simpática ganglionar torácica (simpatectomía), en la electrocoagulación de ésta (simpaticolisis) o en la compresión de la cadena con clips; todas ellas mediante cirugía videotoracoscópica. Se suelen seccionar una o varias estaciones situadas entre T2 y T5 en función del área afecta de hiperhidrosis: T2 para la hiperhidrosis cráneo-facial, T3-4 para la palmar, T3-T5 para la palmar y la axilar asociadas. La técnica resulta de gran utilidad y eficacia en aquellos pacientes con hiperhidrosis primaria que no hayan respondido al tratamiento conservador.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 2 | 8 | 10 |
| 2024 Octubre | 64 | 42 | 106 |
| 2024 Septiembre | 65 | 28 | 93 |
| 2024 Agosto | 86 | 54 | 140 |
| 2024 Julio | 49 | 34 | 83 |
| 2024 Junio | 54 | 29 | 83 |
| 2024 Mayo | 47 | 26 | 73 |
| 2024 Abril | 42 | 29 | 71 |
| 2024 Marzo | 45 | 38 | 83 |
| 2024 Febrero | 53 | 39 | 92 |
| 2024 Enero | 37 | 48 | 85 |
| 2023 Diciembre | 51 | 28 | 79 |
| 2023 Noviembre | 37 | 43 | 80 |
| 2023 Octubre | 37 | 25 | 62 |
| 2023 Septiembre | 23 | 17 | 40 |
| 2023 Agosto | 28 | 14 | 42 |
| 2023 Julio | 43 | 34 | 77 |
| 2023 Junio | 54 | 28 | 82 |
| 2023 Mayo | 49 | 19 | 68 |
| 2023 Abril | 43 | 27 | 70 |
| 2023 Marzo | 24 | 23 | 47 |
| 2023 Febrero | 19 | 21 | 40 |
| 2023 Enero | 24 | 20 | 44 |
| 2022 Diciembre | 27 | 35 | 62 |
| 2022 Noviembre | 11 | 21 | 32 |
| 2022 Octubre | 14 | 20 | 34 |
| 2022 Septiembre | 17 | 32 | 49 |
| 2022 Agosto | 17 | 34 | 51 |
| 2022 Julio | 12 | 27 | 39 |
| 2022 Junio | 18 | 26 | 44 |
| 2022 Mayo | 16 | 38 | 54 |
| 2022 Abril | 31 | 48 | 79 |
| 2022 Marzo | 23 | 58 | 81 |
| 2022 Febrero | 24 | 26 | 50 |
| 2022 Enero | 30 | 32 | 62 |
| 2021 Diciembre | 21 | 39 | 60 |
| 2021 Noviembre | 22 | 39 | 61 |
| 2021 Octubre | 19 | 44 | 63 |
| 2021 Septiembre | 28 | 37 | 65 |
| 2021 Agosto | 28 | 25 | 53 |
| 2021 Julio | 15 | 29 | 44 |
| 2021 Junio | 15 | 27 | 42 |
| 2021 Mayo | 20 | 33 | 53 |
| 2021 Abril | 82 | 55 | 137 |
| 2021 Marzo | 38 | 14 | 52 |
| 2021 Febrero | 50 | 32 | 82 |
| 2021 Enero | 13 | 18 | 31 |
| 2020 Diciembre | 14 | 8 | 22 |
| 2020 Noviembre | 23 | 24 | 47 |
| 2020 Octubre | 18 | 10 | 28 |
| 2020 Septiembre | 25 | 16 | 41 |
| 2020 Agosto | 20 | 22 | 42 |
| 2020 Julio | 24 | 15 | 39 |
| 2020 Junio | 24 | 24 | 48 |
| 2020 Mayo | 21 | 17 | 38 |
| 2020 Abril | 18 | 16 | 34 |
| 2020 Marzo | 18 | 21 | 39 |
| 2020 Febrero | 4 | 4 | 8 |
| 2020 Enero | 0 | 11 | 11 |
| 2019 Diciembre | 0 | 8 | 8 |
| 2019 Noviembre | 0 | 3 | 3 |
| 2019 Octubre | 0 | 2 | 2 |
| 2019 Septiembre | 0 | 2 | 2 |
| 2019 Agosto | 0 | 2 | 2 |
| 2019 Julio | 0 | 3 | 3 |
| 2019 Junio | 0 | 7 | 7 |
| 2019 Mayo | 0 | 42 | 42 |
| 2019 Abril | 1 | 9 | 10 |
| 2019 Marzo | 0 | 4 | 4 |
| 2018 Octubre | 0 | 1 | 1 |
| 2018 Septiembre | 0 | 1 | 1 |
| 2018 Agosto | 0 | 1 | 1 |
| 2018 Julio | 0 | 6 | 6 |
| 2018 Junio | 0 | 1 | 1 |
| 2018 Mayo | 0 | 7 | 7 |
| 2018 Marzo | 1 | 1 | 2 |
| 2018 Febrero | 13 | 6 | 19 |
| 2018 Enero | 14 | 8 | 22 |
| 2017 Diciembre | 17 | 9 | 26 |
| 2017 Noviembre | 11 | 4 | 15 |
| 2017 Octubre | 12 | 4 | 16 |
| 2017 Septiembre | 8 | 12 | 20 |
| 2017 Agosto | 11 | 9 | 20 |
| 2017 Julio | 12 | 10 | 22 |
| 2017 Junio | 15 | 21 | 36 |
| 2017 Mayo | 15 | 25 | 40 |
| 2017 Abril | 15 | 14 | 29 |
| 2017 Marzo | 16 | 37 | 53 |
| 2017 Febrero | 11 | 14 | 25 |
| 2017 Enero | 11 | 11 | 22 |
| 2016 Diciembre | 28 | 8 | 36 |
| 2016 Noviembre | 29 | 7 | 36 |
| 2016 Octubre | 24 | 16 | 40 |
| 2016 Septiembre | 27 | 11 | 38 |
| 2016 Agosto | 25 | 6 | 31 |
| 2016 Julio | 21 | 14 | 35 |
| 2016 Junio | 11 | 8 | 19 |
| 2016 Mayo | 6 | 7 | 13 |
| 2016 Abril | 8 | 30 | 38 |
| 2016 Marzo | 11 | 17 | 28 |
| 2016 Febrero | 13 | 21 | 34 |
| 2016 Enero | 14 | 25 | 39 |
| 2015 Diciembre | 14 | 14 | 28 |
| 2015 Noviembre | 11 | 20 | 31 |
| 2015 Octubre | 11 | 21 | 32 |
| 2015 Septiembre | 12 | 9 | 21 |
| 2015 Agosto | 12 | 7 | 19 |
| 2015 Julio | 24 | 4 | 28 |
| 2015 Junio | 22 | 14 | 36 |
| 2015 Mayo | 54 | 15 | 69 |
| 2015 Abril | 28 | 16 | 44 |
| 2015 Marzo | 20 | 9 | 29 |
| 2015 Febrero | 19 | 12 | 31 |
| 2015 Enero | 17 | 11 | 28 |
| 2014 Diciembre | 20 | 8 | 28 |
| 2014 Noviembre | 21 | 13 | 34 |
| 2014 Octubre | 31 | 14 | 45 |
| 2014 Septiembre | 44 | 11 | 55 |
| 2014 Agosto | 27 | 10 | 37 |
| 2014 Julio | 36 | 18 | 54 |
| 2014 Junio | 30 | 12 | 42 |
| 2014 Mayo | 30 | 14 | 44 |
| 2014 Abril | 27 | 8 | 35 |
| 2014 Marzo | 34 | 18 | 52 |
| 2014 Febrero | 30 | 13 | 43 |
| 2014 Enero | 34 | 24 | 58 |
| 2013 Diciembre | 30 | 16 | 46 |
| 2013 Noviembre | 30 | 14 | 44 |
| 2013 Octubre | 34 | 19 | 53 |
| 2013 Septiembre | 27 | 22 | 49 |
| 2013 Agosto | 13 | 38 | 51 |
| 2013 Julio | 26 | 44 | 70 |
| 2013 Junio | 18 | 30 | 48 |
| 2013 Mayo | 17 | 19 | 36 |
| 2013 Abril | 33 | 14 | 47 |
| 2013 Marzo | 24 | 25 | 49 |
| 2013 Febrero | 23 | 14 | 37 |
| 2013 Enero | 14 | 5 | 19 |
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