2008 Annual Meeting Abstracts
Indications and Outcomes for Video Assisted Thoracic Surgical Sympathectomy
Bruce J. Leavitt, MD.
University of Vermont & Fletcher Allen Health Care, Burlington, VT, USA.
Objective:To evaluate the indications and outcomes for Video Assisted Thoracic Surgery (VATS) sympathectomy.
Design: Retrospective review
Setting:Tertiary Care Center
Patients: Single surgeon, single center
Main Outcome Measures:Complications, patient satisfaction, length of hospital stay (LOS)
Results: From 1993-2008 thirty patients underwent VATS sympathectomy. Indications were complex mediated pain syndrome (RSD) (60%), hyperhidrosis (HHD) (24%) and upper extremity digital vascular insufficiency (VASC) (16%). Eleven males and nineteen females underwent 38 procedures (22 single, 8 bilateral). Seven of the eight bilateral procedures were staged on different days and one had both sides done in a single operative day. Overall age ranged for 28 - 79 years with a mean age of 42.2 years. The mean age for males was 45.7 years (range 29- 79). The mean age for females was 40.2 years (range 28-78). Three complications occurred (8%), one major (thoracotomy for bleeding 3%) and two minor (pneumothorax & urinary retention 5%). Patient satisfaction was as follows: 100% for HHD, 78% for RSD and 83% for VASC. LOS was as follows: D/C day of surgery 22%; POD #1 35%; POD #2 32% & POD #3 or greater 11%.
Conclusions: VATS sympathectomy can be be done with minimal complications and great patient satisfaction. Hyperhidrosis carries the greatest patient satisfaction followed by vascular insufficiency and complex mediated pain syndrome.