Document Detail

Comparison of ultrasonic scalpel to electrocautery in patients undergoing endoscopic thoracic sympathectomy.
MedLine Citation:
PMID:  19766797     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Sympathectomy is an effective treatment for hyperhidrosis. The ultrasonic scalpel and electrocautery have been used for the procedure, but the use of the ultrasonic scalpel has been promoted as superior to that of electrocautery. This study explored whether a reusable electrocautery probe was equally as effective and safe as the ultrasonic scalpel for sympathectomy. METHODS: We retrospectively analyzed 140 consecutive patients. The ultrasonic scalpel (HDH 05, Ethicon Endo-Surgery, Cincinnati, OH) was used in 70 patients (group 1) and a reusable 5-mm cautery hook (Edlo, Canoas, Brazil) was used in 70 patients (group 2). End points were improvement in symptoms (% improvement score), length of stay, return to work, and complications. Data were analyzed using two-tailed t test and the chi(2) (p = 0.05 was significant). Data are mean +/- standard deviation. RESULTS: Follow-up was 27.2 +/- 8.4 months. Groups were similar in demographics, disease site, and level of sympathectomy. There was no significant difference in improvement score by site. The feet had the least improvement score (36.5% +/- 32.3%), and the hands the highest improvement score (97.0% +/- 11.3%). Length of stay was similar, 11.4 +/- 5.9 (group 1) vs 10.1 +/- 5.4 hours (group 2). Return to work in group 1 was 4.8 +/- 2.7 vs 5.7 +/- 3.6 days (p = 0.09). Group 1 had 14 complications and group 2 had 7 (p = 0.16). CONCLUSIONS: We could not demonstrate a clear advantage in the use of the ultrasonic scalpel.
Benny Weksler; Mary Pollice; Zemilson B B Souza; Rodrigo Gavina
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  88     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-21     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1138-41     Citation Subset:  AIM; IM    
Division of Cardiothoracic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
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MeSH Terms
Electrocoagulation / instrumentation*
Equipment Design
Follow-Up Studies
Hyperhidrosis / surgery*
Retrospective Studies
Sympathectomy / methods*
Thoracic Nerves / surgery*
Thoracoscopy / methods*
Treatment Outcome
Ultrasonic Therapy / instrumentation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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