Thoracic lymphadenectomy in video-assisted mini-invasive thoracic surgery. First experience]

The Authors report their experience in the thoracoscopic surgical treatment of neurovascular abnormalities of the upper extremities. The experience acquired in the last two years with mini-invasive video-assisted thoracic surgery of the pleura and lung forced the Authors to perform thoracic sympathectomy following the same approach. In this way 4 thoracic sympathectomies were performed in 3 patients. Two of them presented Raynaud's phenomenon, and one was affected by bilateral idiophatic upper limb hyperhidrosis. The operation is performed thanks to 3 12mm Thoracoports that allow the introduction of the telescope and operative instruments. It is easy to recognize and remove the sympathetic gangliar chain from T2 to T3. The short operative time required, the absence of mortality and morbidity, the regression of the symptomatology, the rapid return to work authorize to consider endoscopic transthoracic sympathectomy the gold standard in the treatment of neurovascular abnormalities of the upper extremities.