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Kuhajda I, Djuric D, Milos K, Bijelovic M, Milosevic M, Ilincic D, Ilic M, Koledin B, Kuhajda D, Tsakiridis K, Mpakas A, Zarogoulidis K, Kioumis I, Lampaki S, Zarogoulidis P, Komarcevic M. Semi-Fowler vs. lateral decubitus position for thoracoscopic sympathectomy in treatment of primary focal hyperhidrosis. J Thorac Dis 2015; 7:S5-S11. [PMID: 25774308 DOI: 10.3978/j.issn.2072-1439.2015.01.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 12/30/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study is to compare usefulness of Semi-Fowler position vs. lateral decubitus position for thoracoscopic sympathectomy in treatment of primary focal hyperhidrosis. MATERIALS AND METHODS From January 2009 to January 2010, 263 consecutive patients with palmar and axillar hyperhidrosis underwent thoracoscopic sympathectomy Th2-Th4. Patients were divided into two groups: group A (n=133) underwent thoracoscopic sympathectomy through lateral decubitus using double lumen endotracheal intubation, and group B (n=130) underwent thoracoscopic sympathectomy through Semi-Fowler supine position (semi sitting with arm abducted) using single lumen endotracheal intubation without insufflation of CO2, but with short apnea period. All operations were performed through two 5 mm operating ports, videothoracoscopic camera 0° and endoscopic ultrasound activated harmonic scalpel. RESULTS There were 107 males and 156 females with median age 30.31±8.35 years. Two groups were comparable in gender, age, severity of sweating. All operations were successfully performed with no complications or perioperative morbidity. For group A average operation time for both sides was 31.2±3.87 min and for group B average time was 14.19±4.98 min. In group B apnea period per one lung lasts 2.86±1.15 min and during that period observed saturation was 92.65%±5.66% without significant cardiorespiratory disturbances. Pleural drains were taken off on operation table after forced manually lung reexpansion. Patients were discharged from hospital for few hours, after the operation and radiologic confirmation of complete lung reexpansion. CONCLUSIONS Based on this data (shorter operating time, lack of incomplete lung collapse, insignificant apnea and better reexpansion of lungs) we concluded that thoracoscopic sympathectomy through Semi-Fowler supine position is highly effective and easy to perform for primary hyperhidrosis.
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Affiliation(s)
- Ivan Kuhajda
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Dejan Djuric
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Koledin Milos
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Milorad Bijelovic
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Misel Milosevic
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Dejan Ilincic
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Miroslav Ilic
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Bojan Koledin
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Danijela Kuhajda
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Kosmas Tsakiridis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Andreas Mpakas
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Konstantinos Zarogoulidis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Ioannis Kioumis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Sofia Lampaki
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Paul Zarogoulidis
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
| | - Milana Komarcevic
- 1 Thoracic Surgery Department, Institute for Pulmonary Diseases of Vojvodina, Faculty of Medicine, 2 Department of Medical Rehabilitation, University of Novi Sad, Novi Sad, Serbia; 3 Cardiothoracic Surgery Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece ; 4 Pulmonary-Oncology, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Department of Anesthesia and Intensive Care, Clinic for Thoracic Surgery, The Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, University of Novi Sad, Serbia
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