The Experts below are selected from a list of 246 Experts worldwide ranked by ideXlab platform
Toby A Prevost - One of the best experts on this subject based on the ideXlab platform.
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management of lower limb complex regional pain syndrome type 1 an evaluation of percutaneous radiofrequency thermal lumbar Sympathectomy versus phenol lumbar sympathetic neurolysis a pilot study
Anesthesia & Analgesia, 2008Co-Authors: Prashanth S Manjunath, T S Jayalakshmi, G P Dureja, Toby A PrevostAbstract:BACKGROUND: Complex regional pain syndrome type 1 can be difficult to treat. The purpose of this study was to compare the safety and efficacy of two therapeutic options: percutaneous radiofrequency thermal lumbar Sympathectomy and lumbar sympathetic neurolysis. METHODS: We randomized 20 patients to receive percutaneous radiofrequency lumbar Sympathectomy or lumbar sympathetic neurolysis with phenol 7% in lower limb complex regional pain syndrome type 1. The study end points were pain relief and side effects. RESULTS: Within each group, there were statistically significant reductions from baseline in various pain scores after the procedure. However, there was no statistically significant difference in mean pain scores between the groups. CONCLUSIONS: Based on this pilot study, radiofrequency lumbar Sympathectomy may be comparable to phenol lumbar Sympathectomy. A larger trial is required to confirm these findings.
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management of lower limb complex regional pain syndrome type 1 an evaluation of percutaneous radiofrequency thermal lumbar Sympathectomy versus phenol lumbar sympathetic neurolysis a pilot study
Anesthesia & Analgesia, 2008Co-Authors: Prashanth S Manjunath, T S Jayalakshmi, G P Dureja, Toby A PrevostAbstract:BACKGROUND: Complex regional pain syndrome type 1 can be difficult to treat. The purpose of this study was to compare the safety and efficacy of two therapeutic options: percutaneous radiofrequency thermal lumbar Sympathectomy and lumbar sympathetic neurolysis. METHODS: We randomized 20 patients to receive percutaneous radiofrequency lumbar Sympathectomy or lumbar sympathetic neurolysis with phenol 7% in lower limb complex regional pain syndrome type 1. The study end points were pain relief and side effects. RESULTS: Within each group, there were statistically significant reductions from baseline in various pain scores after the procedure. However, there was no statistically significant difference in mean pain scores between the groups. CONCLUSIONS: Based on this pilot study, radiofrequency lumbar Sympathectomy may be comparable to phenol lumbar Sympathectomy. A larger trial is required to confirm these findings.
Hans K. Pilegaard - One of the best experts on this subject based on the ideXlab platform.
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Thoracoscopic Sympathectomy for Isolated Facial Blushing
The Annals of thoracic surgery, 2006Co-Authors: Peter B. Licht, Lars Ladegaard, Hans K. PilegaardAbstract:Background Facial blushing is one of the most peculiar of human expressions and has become a cardinal symptom of social phobia. The pathophysiology is unclear and the prevalence is unknown. Thoracoscopic Sympathectomy may cure the symptom, but very few surgeons treat patients with isolated facial blushing. The literature is limited, and there are few long-term follow-up studies. Methods A follow-up study by questionnaire in 180 consecutive patients who underwent thoracoscopic Sympathectomy for isolated facial blushing at two Danish university hospitals during a 6-year period. Patients routinely underwent T2 Sympathectomy at the university hospital in Aarhus (n = 101) and T2-T3 Sympathectomy at the university hospital in Odense (n = 79). Results The questionnaire was returned by 96% of the patients after a median follow-up time of 20 months. Overall, 90% of the patients had some effect from the operation, and the result was excellent or satisfactory in 75%. There was no significant difference between the two extents of Sympathectomy. Compensatory sweating occurred in 88% of all patients and was significantly more frequent after T2-T3 Sympathectomy ( p = 0.02) Ten percent of our patients regretted the operation because of side effects or no effect of the operation. Conclusions This study demonstrates that thoracoscopic Sympathectomy is an effective treatment for isolated facial blushing. The majority of patients achieve an excellent or satisfactory long-term result. Our results suggest that a T2 Sympathectomy is superior for patients with isolated facial blushing because side effects are lower compared with a T2-T3 Sympathectomy.
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Gustatory side effects after thoracoscopic Sympathectomy.
The Annals of thoracic surgery, 2006Co-Authors: Peter B. Licht, Hans K. PilegaardAbstract:Background Compensatory sweating is a frequent side effect after thoracoscopic Sympathectomy for primary hyperhidrosis. Gustatory sweating is less commonly reported. It is defined as facial sweating when eating certain foods (particularly spicy food or acidic fruits) and has no generally accepted pathophysiologic explanation. We decided to investigate this phenomenon in patients who underwent thoracoscopic Sympathectomy for primary hyperhidrosis and analyze whether the occurrence was influenced by the extent of Sympathectomy. Methods During an 8-year period (1997 to 2005) a total of 238 patients were treated by thoracoscopic Sympathectomy for primary hyperhidrosis or blushing. Sympathectomy was performed bilaterally at T2 for facial hyperhidrosis or blushing (n = 97), T2–T3 for palmar hyperhidrosis (n = 76), and T2–T4 for axillary hyperhidrosis (n = 65). All patients received the same questionnaire at follow-up. Results The questionnaire was returned by 96% of patients after a median of 17 months. Overall, gustatory sweating occurred in 32% of patients, and the incidence was significantly associated with extent of Sympathectomy ( p = 0.04). However, because the extent of Sympathectomy was always decided by the location of primary hyperhidrosis, the latter may also explain the risk of gustatory sweating. Conclusions Gustatory sweating is a frequent side effect after thoracoscopic Sympathectomy. This is the first study to report that its incidence is significantly related to the extent of Sympathectomy or the location of primary hyperhidrosis. Although there is no pathophysiologic explanation of gustatory sweating, these findings should be considered before planning thoracoscopic Sympathectomy and patients should be thoroughly informed.
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Thoracoscopic Sympathectomy for axillary hyperhidrosis: the influence of T4.
The Annals of thoracic surgery, 2005Co-Authors: Peter B. Licht, Ole Dan Jørgensen, Lars Ladegaard, Hans K. PilegaardAbstract:Background Recent data suggest that severe compensatory sweating after Sympathectomy for hyperhidrosis is more common than previously reported. In particular, T2-T4 Sympathectomy for axillary hyperhidrosis leads to significantly more disabling sweating compared with T2-T3 Sympathectomy for palmar hyperhidrosis. However, it is not known whether this is a result of the additional transection of the T4 segment or if patients with primary axillary hyperhidrosis are more prone to experience disabling compensatory sweating. Methods A follow-up study by questionnaire was made of 100 consecutive patients who underwent thoracoscopic Sympathectomy for axillary hyperhidrosis at two university hospitals. Patients underwent T2-T3 Sympathectomy (n = 35) or T2-T4 Sympathectomy (n = 65) depending on the surgeon's preference. Results The questionnaire was returned by 91% of patients after a median of 31 months. Compensatory sweating occurred in 90% of patients and was so severe in 61% that they often had to change clothes during the day. There were no significant differences in occurrence or severity of compensatory sweating between the two extents of Sympathectomy. Surgical outcome, however, was significantly better after T2-T4 Sympathectomy. Conclusions In contrast with previous reports, the incidence of compensatory sweating was not significantly related to the extent of Sympathectomy for axillary hyperhidrosis. This result suggests that patients with primary axillary hyperhidrosis are more prone to experience compensatory sweating. Although the majority of patients with axillary hyperhidrosis were satisfied after thoracoscopic Sympathectomy, many regret the operation. Patients should undergo surgery only if medical treatments fail; and provided there is an indication, we recommend T2-T4 Sympathectomy.
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Severity of compensatory sweating after thoracoscopic Sympathectomy.
The Annals of thoracic surgery, 2004Co-Authors: Peter B. Licht, Hans K. PilegaardAbstract:Abstract Background Compensatory sweating is a well-known side effect after Sympathectomy for hyperhidrosis. It is often claimed to correlate with the extent of Sympathectomy, but results from the literature are conflicting, and few have actually considered differences in the intensity of compensatory sweating. Methods A total of 158 patients underwent thoracoscopic Sympathectomy for primary hyperhidrosis or blushing, or both. Sympathectomy was performed bilaterally at Th2 for facial hyperhidrosis/blushing (n = 49), Th2-3 for palmar hyperhidrosis (n = 62), and Th2-4 for axillary hyperhidrosis (n = 47). Results Follow-up by questionnaire was possible in 94% of patients after a median of 26 months. Compensatory sweating occurred in 89% of patients and was so severe in 35% that they often had to change their clothes during the day. The frequency of compensatory sweating was not significantly different among the three groups, but severity was significantly higher after Th2-4 Sympathectomy for axillary hyperhidrosis ( p = 0.04). Gustatory sweating occurred in 38% of patients, and 16% of patients regretted the operation. Conclusions Compensatory and gustatory sweating were remarkably frequent side effects after thoracoscopic Sympathectomy for primary hyperhidrosis. We found no significant difference between the level of Sympathectomy and the occurence of compensatory sweating. However, it appears that this is the first study to demonstrate that severe sweating is significantly more frequent after Th2-4 Sympathectomy for axillary hyperhidrosis. We encourage informing patients thoroughly about these side effects before surgery.
Prashanth S Manjunath - One of the best experts on this subject based on the ideXlab platform.
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management of lower limb complex regional pain syndrome type 1 an evaluation of percutaneous radiofrequency thermal lumbar Sympathectomy versus phenol lumbar sympathetic neurolysis a pilot study
Anesthesia & Analgesia, 2008Co-Authors: Prashanth S Manjunath, T S Jayalakshmi, G P Dureja, Toby A PrevostAbstract:BACKGROUND: Complex regional pain syndrome type 1 can be difficult to treat. The purpose of this study was to compare the safety and efficacy of two therapeutic options: percutaneous radiofrequency thermal lumbar Sympathectomy and lumbar sympathetic neurolysis. METHODS: We randomized 20 patients to receive percutaneous radiofrequency lumbar Sympathectomy or lumbar sympathetic neurolysis with phenol 7% in lower limb complex regional pain syndrome type 1. The study end points were pain relief and side effects. RESULTS: Within each group, there were statistically significant reductions from baseline in various pain scores after the procedure. However, there was no statistically significant difference in mean pain scores between the groups. CONCLUSIONS: Based on this pilot study, radiofrequency lumbar Sympathectomy may be comparable to phenol lumbar Sympathectomy. A larger trial is required to confirm these findings.
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management of lower limb complex regional pain syndrome type 1 an evaluation of percutaneous radiofrequency thermal lumbar Sympathectomy versus phenol lumbar sympathetic neurolysis a pilot study
Anesthesia & Analgesia, 2008Co-Authors: Prashanth S Manjunath, T S Jayalakshmi, G P Dureja, Toby A PrevostAbstract:BACKGROUND: Complex regional pain syndrome type 1 can be difficult to treat. The purpose of this study was to compare the safety and efficacy of two therapeutic options: percutaneous radiofrequency thermal lumbar Sympathectomy and lumbar sympathetic neurolysis. METHODS: We randomized 20 patients to receive percutaneous radiofrequency lumbar Sympathectomy or lumbar sympathetic neurolysis with phenol 7% in lower limb complex regional pain syndrome type 1. The study end points were pain relief and side effects. RESULTS: Within each group, there were statistically significant reductions from baseline in various pain scores after the procedure. However, there was no statistically significant difference in mean pain scores between the groups. CONCLUSIONS: Based on this pilot study, radiofrequency lumbar Sympathectomy may be comparable to phenol lumbar Sympathectomy. A larger trial is required to confirm these findings.
Peter B. Licht - One of the best experts on this subject based on the ideXlab platform.
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Thoracoscopic Sympathectomy for Isolated Facial Blushing
The Annals of thoracic surgery, 2006Co-Authors: Peter B. Licht, Lars Ladegaard, Hans K. PilegaardAbstract:Background Facial blushing is one of the most peculiar of human expressions and has become a cardinal symptom of social phobia. The pathophysiology is unclear and the prevalence is unknown. Thoracoscopic Sympathectomy may cure the symptom, but very few surgeons treat patients with isolated facial blushing. The literature is limited, and there are few long-term follow-up studies. Methods A follow-up study by questionnaire in 180 consecutive patients who underwent thoracoscopic Sympathectomy for isolated facial blushing at two Danish university hospitals during a 6-year period. Patients routinely underwent T2 Sympathectomy at the university hospital in Aarhus (n = 101) and T2-T3 Sympathectomy at the university hospital in Odense (n = 79). Results The questionnaire was returned by 96% of the patients after a median follow-up time of 20 months. Overall, 90% of the patients had some effect from the operation, and the result was excellent or satisfactory in 75%. There was no significant difference between the two extents of Sympathectomy. Compensatory sweating occurred in 88% of all patients and was significantly more frequent after T2-T3 Sympathectomy ( p = 0.02) Ten percent of our patients regretted the operation because of side effects or no effect of the operation. Conclusions This study demonstrates that thoracoscopic Sympathectomy is an effective treatment for isolated facial blushing. The majority of patients achieve an excellent or satisfactory long-term result. Our results suggest that a T2 Sympathectomy is superior for patients with isolated facial blushing because side effects are lower compared with a T2-T3 Sympathectomy.
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Gustatory side effects after thoracoscopic Sympathectomy.
The Annals of thoracic surgery, 2006Co-Authors: Peter B. Licht, Hans K. PilegaardAbstract:Background Compensatory sweating is a frequent side effect after thoracoscopic Sympathectomy for primary hyperhidrosis. Gustatory sweating is less commonly reported. It is defined as facial sweating when eating certain foods (particularly spicy food or acidic fruits) and has no generally accepted pathophysiologic explanation. We decided to investigate this phenomenon in patients who underwent thoracoscopic Sympathectomy for primary hyperhidrosis and analyze whether the occurrence was influenced by the extent of Sympathectomy. Methods During an 8-year period (1997 to 2005) a total of 238 patients were treated by thoracoscopic Sympathectomy for primary hyperhidrosis or blushing. Sympathectomy was performed bilaterally at T2 for facial hyperhidrosis or blushing (n = 97), T2–T3 for palmar hyperhidrosis (n = 76), and T2–T4 for axillary hyperhidrosis (n = 65). All patients received the same questionnaire at follow-up. Results The questionnaire was returned by 96% of patients after a median of 17 months. Overall, gustatory sweating occurred in 32% of patients, and the incidence was significantly associated with extent of Sympathectomy ( p = 0.04). However, because the extent of Sympathectomy was always decided by the location of primary hyperhidrosis, the latter may also explain the risk of gustatory sweating. Conclusions Gustatory sweating is a frequent side effect after thoracoscopic Sympathectomy. This is the first study to report that its incidence is significantly related to the extent of Sympathectomy or the location of primary hyperhidrosis. Although there is no pathophysiologic explanation of gustatory sweating, these findings should be considered before planning thoracoscopic Sympathectomy and patients should be thoroughly informed.
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Thoracoscopic Sympathectomy for axillary hyperhidrosis: the influence of T4.
The Annals of thoracic surgery, 2005Co-Authors: Peter B. Licht, Ole Dan Jørgensen, Lars Ladegaard, Hans K. PilegaardAbstract:Background Recent data suggest that severe compensatory sweating after Sympathectomy for hyperhidrosis is more common than previously reported. In particular, T2-T4 Sympathectomy for axillary hyperhidrosis leads to significantly more disabling sweating compared with T2-T3 Sympathectomy for palmar hyperhidrosis. However, it is not known whether this is a result of the additional transection of the T4 segment or if patients with primary axillary hyperhidrosis are more prone to experience disabling compensatory sweating. Methods A follow-up study by questionnaire was made of 100 consecutive patients who underwent thoracoscopic Sympathectomy for axillary hyperhidrosis at two university hospitals. Patients underwent T2-T3 Sympathectomy (n = 35) or T2-T4 Sympathectomy (n = 65) depending on the surgeon's preference. Results The questionnaire was returned by 91% of patients after a median of 31 months. Compensatory sweating occurred in 90% of patients and was so severe in 61% that they often had to change clothes during the day. There were no significant differences in occurrence or severity of compensatory sweating between the two extents of Sympathectomy. Surgical outcome, however, was significantly better after T2-T4 Sympathectomy. Conclusions In contrast with previous reports, the incidence of compensatory sweating was not significantly related to the extent of Sympathectomy for axillary hyperhidrosis. This result suggests that patients with primary axillary hyperhidrosis are more prone to experience compensatory sweating. Although the majority of patients with axillary hyperhidrosis were satisfied after thoracoscopic Sympathectomy, many regret the operation. Patients should undergo surgery only if medical treatments fail; and provided there is an indication, we recommend T2-T4 Sympathectomy.
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Severity of compensatory sweating after thoracoscopic Sympathectomy.
The Annals of thoracic surgery, 2004Co-Authors: Peter B. Licht, Hans K. PilegaardAbstract:Abstract Background Compensatory sweating is a well-known side effect after Sympathectomy for hyperhidrosis. It is often claimed to correlate with the extent of Sympathectomy, but results from the literature are conflicting, and few have actually considered differences in the intensity of compensatory sweating. Methods A total of 158 patients underwent thoracoscopic Sympathectomy for primary hyperhidrosis or blushing, or both. Sympathectomy was performed bilaterally at Th2 for facial hyperhidrosis/blushing (n = 49), Th2-3 for palmar hyperhidrosis (n = 62), and Th2-4 for axillary hyperhidrosis (n = 47). Results Follow-up by questionnaire was possible in 94% of patients after a median of 26 months. Compensatory sweating occurred in 89% of patients and was so severe in 35% that they often had to change their clothes during the day. The frequency of compensatory sweating was not significantly different among the three groups, but severity was significantly higher after Th2-4 Sympathectomy for axillary hyperhidrosis ( p = 0.04). Gustatory sweating occurred in 38% of patients, and 16% of patients regretted the operation. Conclusions Compensatory and gustatory sweating were remarkably frequent side effects after thoracoscopic Sympathectomy for primary hyperhidrosis. We found no significant difference between the level of Sympathectomy and the occurence of compensatory sweating. However, it appears that this is the first study to demonstrate that severe sweating is significantly more frequent after Th2-4 Sympathectomy for axillary hyperhidrosis. We encourage informing patients thoroughly about these side effects before surgery.
T S Jayalakshmi - One of the best experts on this subject based on the ideXlab platform.
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management of lower limb complex regional pain syndrome type 1 an evaluation of percutaneous radiofrequency thermal lumbar Sympathectomy versus phenol lumbar sympathetic neurolysis a pilot study
Anesthesia & Analgesia, 2008Co-Authors: Prashanth S Manjunath, T S Jayalakshmi, G P Dureja, Toby A PrevostAbstract:BACKGROUND: Complex regional pain syndrome type 1 can be difficult to treat. The purpose of this study was to compare the safety and efficacy of two therapeutic options: percutaneous radiofrequency thermal lumbar Sympathectomy and lumbar sympathetic neurolysis. METHODS: We randomized 20 patients to receive percutaneous radiofrequency lumbar Sympathectomy or lumbar sympathetic neurolysis with phenol 7% in lower limb complex regional pain syndrome type 1. The study end points were pain relief and side effects. RESULTS: Within each group, there were statistically significant reductions from baseline in various pain scores after the procedure. However, there was no statistically significant difference in mean pain scores between the groups. CONCLUSIONS: Based on this pilot study, radiofrequency lumbar Sympathectomy may be comparable to phenol lumbar Sympathectomy. A larger trial is required to confirm these findings.
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management of lower limb complex regional pain syndrome type 1 an evaluation of percutaneous radiofrequency thermal lumbar Sympathectomy versus phenol lumbar sympathetic neurolysis a pilot study
Anesthesia & Analgesia, 2008Co-Authors: Prashanth S Manjunath, T S Jayalakshmi, G P Dureja, Toby A PrevostAbstract:BACKGROUND: Complex regional pain syndrome type 1 can be difficult to treat. The purpose of this study was to compare the safety and efficacy of two therapeutic options: percutaneous radiofrequency thermal lumbar Sympathectomy and lumbar sympathetic neurolysis. METHODS: We randomized 20 patients to receive percutaneous radiofrequency lumbar Sympathectomy or lumbar sympathetic neurolysis with phenol 7% in lower limb complex regional pain syndrome type 1. The study end points were pain relief and side effects. RESULTS: Within each group, there were statistically significant reductions from baseline in various pain scores after the procedure. However, there was no statistically significant difference in mean pain scores between the groups. CONCLUSIONS: Based on this pilot study, radiofrequency lumbar Sympathectomy may be comparable to phenol lumbar Sympathectomy. A larger trial is required to confirm these findings.
