Simpaticectomia endoscopica toracica con l'uso di endoclips nel trattamento della fobia sociale: esperienza di Monza

Aim. Facial blushing represents the peculiar symptom in social phobia and is defined as the "hallmark of embarrassment". At present, endoscopie thoracic sympathectomy (ETS) is the technique only able to guarantee longterm results in the treatment of sympathetic disorders. The aim of our study was to evaluate results, complications and the true value of 52 ETSs by two-port approach with the use of endoclips in patients with isolated facial blushing or in association with hyperhidrosls. Methods. A retrospective review of 52 subjects who underwent standard ETS by clamping between September 2002 and April 2005 was carried out. This surgical practice was performed in 26 cases (50%) for isolated facial blushing only and in other 26 cases (50%) for facial blushing associated to hyperhidrosfe with changeable localizations. Under endoscopie guidance we operated an endoscopie sympathetic block (ESB) with interruption of the intergangliar trunk at the level of T2-T3 in 51 patients (98.07%). In 1 patient (1.92%) we performed a sympathetic block with the complete exclusion of T3 thoracic ganglion. Results. There were no intra and postoperative deaths. The effect rate was excellent in all patients with early complications in one patient (1.92%) only. Conclusions. ETS by clamping is safe and effective. Patients referred an high satisfaction in terms of complications and quality of life; specific early and late diseases are neglectables