{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:59:05Z","timestamp":1782997145510,"version":"3.54.5"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2020,10]]},"abstract":"Zusammenfassung<\/jats:title>\n Zielsetzung Der vorliegende Beitrag zeigt Schritt f\u00fcr Schritt die thorakoskopische Sympathektomie bei prim\u00e4r fokaler Hyperhidrosis.<\/jats:p>\n Indikation Schwitzen ist f\u00fcr die Thermoregulation ein physiologischer und lebenswichtiger Mechanismus. \u00dcberproportional gesteigertes Schwitzen, die sog. Hyperhidrose, kann zu erheblichem Leidensdruck bei Patienten aller Altersklassen f\u00fchren. Man unterscheidet hierbei eine generalisierte, meist durch eine Grunderkrankung bedingte Hyperhidrose von einer fokalen, meist idiopathischen Form, die \u00fcberwiegend H\u00e4nde, Achseln, Gesicht und F\u00fc\u00dfe betrifft. Die h\u00e4ufigste Indikation weltweit f\u00fcr eine thorakale Sympathektomie sind die ansonsten therapierefrakt\u00e4re, idiopathische palmare und axill\u00e4re Hyperhidrose, bei denen eine pathologische Sympathikusinnervation der lokalen ekkrinen Schwei\u00dfdr\u00fcsen an H\u00e4nden und in den Axillen besteht.<\/jats:p>\n Methode Beschrieben wird die thorakoskopische Sympathektomie in R\u00fcckenlage mit Oberk\u00f6rperhochlagerung bei einer adoleszenten Patientin. Unter Vollnarkose und Single-Lumen-Ventilation wird neben einem 3-mm-Kameratrokar in der Axillarfalte ein weiterer 5-mm-Trokar im lateralen 4. oder 5.\u2009Interkostalraum (ICR) platziert (im Verlauf der Brustfalte bei weiblichen Patienten). Der Grenzstrang mit den sympathischen Ganglien thorakal (Th) 2\u200a\u2013\u200a4 wird sicher identifiziert, koaguliert und mittels Diathermie auf dem Caput costae jeweils durchtrennt. In der Regel wird die Operation in gleicher Sitzung beidseits thorakal durchgef\u00fchrt, da das bilaterale, lokal gesteigerte Schwitzen zu den Diagnostikkriterien der Hyperhidrosis z\u00e4hlt.<\/jats:p>\n Schlussfolgerung Die thorakoskopische Sympathektomie ist, insbesondere bei fokaler palmarer und axill\u00e4rer Hyperhidrosis, aus Sicht der Autoren ein geeignetes Therapieverfahren, um die betreffenden Ganglien und den Grenzstrang selektiv zu durchtrennen. Mit der beschriebenen minimalinvasiven Operationstechnik ist eine anhaltend langfristige Symptomlinderung f\u00fcr die Patienten erreichbar.<\/jats:p>","DOI":"10.1055\/a-1186-2596","type":"journal-article","created":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T22:42:45Z","timestamp":1595544165000},"page":"421-424","source":"Crossref","is-referenced-by-count":1,"title":["Thorakoskopische Sympathektomie bei palmarer und axill\u00e4rer Hyperhidrosis"],"prefix":"10.1055","volume":"145","author":[{"given":"Stephan","family":"Rohleder","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kinderchirurgie, Universit\u00e4tsklinikum Mainz, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"M\u00fcnsterer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kinderchirurgie, Universit\u00e4tsklinikum Mainz, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"G\u00f6deke","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kinderchirurgie, Universit\u00e4tsklinikum Mainz, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/S0190-9622(89)70063-3","article-title":"Biology of sweat glands and their disorders. 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