Evaluation of the Impact of Transthoracic Endoscopic Sympathectomy on Patients with Palmar Hyperhydrosis

AbstractObjectives. We assessed the impact of transthoracic endoscopic sympathectomy (TES) on the quality of life of patients with palmar hyperhydrosis.Design. A retrospective questionnaire based study.Methods. Patients undergoing TES at our institution between 1997 and 2002 received a SF-36 quality of life postal questionnaire. The pre- and post-operative symptoms were assessed. Statistical analysis was by means of the Student's t test.Results. Ninety-four TES were carried out in 62 patients. Forty-one cases were female. The age range was 17–64 years. The mean follow-up period was 38.46 months. Mean hospital stay was 3 days. Compensatory hyperhydrosis was reported in 29 cases and only considered severe in four cases (9.7%). Forty-one patients replied to the questionnaire (66%). The overall quality of life (as assessed by the SF-36 form) was unanimously improved (p<0.0009) and demonstrated significant improvements in social functioning (p<0.0002), physical role limitations (p<0.0007), emotional well-being (p<0.0007) and overall energy levels (p<0.05).Conclusion. TES resulted in significant improvements inpatient's overall quality of life, social and emotional functioning. The procedure is associated with minimal morbidity and only a short inpatient stay is required. Patients should be cautioned on the possibility of compensatory hyperhydrosis which may occur in a small number of cases

Novel instrumentation for real-time monitoring using miniaturized flow systems with integrated biosensors

A prototype miniaturized Total Chemical Analysis System (μTAS) has been developed and applied to on-line monitoring of glucose and lactate in the core blood of anaesthetized dogs. The system consists of a highly efficient microdialysis sampling interface sited in a small-scale extracorporeal shunt circuit ('MiniShunt'), a silicon machined microflow manifold and integrated biosensor array for glucose and lactate detection with associated computer software for analytical process control. During in-vivo testing the device allowed real-time on-screen monitoring of glucose and lactate with system response times of less than 5 min, made possible by the small dead volume of the microflow system. On-line glucose and lactate measurements were made in the basal state as well as during intravenous infusion of glucose or lactate. The prototype μTAS is currently suitable for trend monitoring but refinements are necessary before application of the system for determination of individual lactate values