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Background: Endoscopic thoracic sympathectomy/sympathotomy is gold standard of treatment for primary hyperhidrosis. Compensatory hyperhidrosis following surgery and partial response to surgery in some patients can significantly affect surgery outcome and patient satisfaction. In this study we investigated predictors of success rate, side effects, and satisfaction of our patients following ETS over a 10-year period., Methods: We retrospectively reviewed result of 200 Endoscopic thoracic sympathotomy surgeries that was performed in a single center to treat craniofacial, palmar, or axillary primary hyperhidrosis over a 10-year period. Patients were asked to report success of surgery to resolve their primary hyperhidrosis, development of compensatory hyperhidrosis, its severity, and their overall satisfaction with surgery., Results: Palmar hyperhidrosis was resolved in 167 (94%) patients. Craniofacial hyperhidrosis was resolved in 66 (84%) patients. Axillary hyperhidrosis was resolved in 68 (50%) patients. Compensatory hyperhidrosis developed in 176 (88%) patients. 44 (22%) patients had mild CHH, 79 (40%) patients developed moderate CHH, and 52 (26%) patients experienced severe CHH. A total of 173 (87%) patients were satisfied with surgery. 19 (9%) patients were not satisfied with ETS and 8 (4%) patients regretted ETS. Lower body mass index and grade IV primary hyperhidrosis were found to be independent predictors of patient satisfaction. Pure axillary primary hyperhidrosis was a negative predictor of patient satisfaction., Conclusion: Best results of ETS are achieved in patients with grade IV PHH and lower body mass indexes. Outcome of ETS for treating axillary PHH is not favorable., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background : Minimal access mediastinal surgery (MAMS) is usually performed under general anaesthesia with double lumen tubes (DLT). The aim of this study is to evaluate two lung ventilation through single lumen tubes (SLT) during thoracoscopic sympathectomy for hyperhidrosis and thoracoscopic thymectomy for myasthenia gravis. Methods : In this prospective non-randomized study, MAMS was performed in 58 patients with hyperhidrosis and 42 patients with myasthenia gravis, from January 2002 to December 2008. Patients were intubated with a DLT or SLT, 50 patients in each group. In the DLT group, endobronchial tubes were placed using the traditional blind approach and one lung ventilation was confirmed clinically. In the SLT group, the hemithorax was insufflated with CO2 in conjunction with two-lung anaesthesia. All the patients were evaluated for haemodynamic stability, oxygen saturation of haemoglobin (Spo2), end-tidal Pco2 (ETPco2), times required for intubation and surgery, satisfaction of surgeon with regard to exposure and postoperative complications. Results : In the SLT group, all the patients had stable haemodynamic and ventilation parameters. In the DLT group, haemodynamic instability occurred in two, decrease in Spo2 in four and increase in ETPco2 in three patients. One patient in the DLT group developed vocal cord granuloma two months later. Time required for surgery and the surgeon′s opinion with regard to exposure were similar for both groups. Conclusion : Thoracoscopic surgery when used in cases where a well-collapsed lung may not be essential, since surgery is not performed on the lung itself, does not require DLT. SLT is safe in MAMS. It provides good surgical exposure and decreases the cost, time and undesirable complications of DLT.