Video-assisted Thoracoscopic Sympathectomy for Palmar Hyperhidrosis: Results in 102 Cases

Introduction Primary palmar hyperhidrosis is an abnormal over-sweating of palms. It is usually associated with plantar hyperhidrosis. Video-assisted thoracoscopic sympathectomy is the treatment of choice for palmar hyperhidrosis; however, it may affect plantar hyperhidrosis. Objectives The aim of this study was to evaluate the effect of thoracoscopic sympathectomy on plantar hyperhidrosis. Methods This prospective study included patients who presented to the Cardiothoracic Surgery Department with primary palmo-planter hyperhidrosis and received thoracoscopic sympathectomy between January 2014 and December 2018. Preoperatively, patients scored subjectively the degree of palmar and plantar hyperhidrosis on Visual Analogue Scale. Following surgery, scoring was performed at three intervals: 7, 30, and 180 days. Presence of compensatory sweating and its scoring was obtained at the same intervals. Complications and patient satisfaction were recorded. Results A total of 518 patients were included. Complication rate, excluding compensatory hyperhidrosis, was 2.7%. Preoperative Visual Analogue Scale score for palmar hyperhidrosis was 9.9 ± 3.8 that following thoracoscopic sympathectomy decreased to 0.041 ± 0.2 on the seventh postoperative day. Further decrease to 0.3 ± 0.16 was noted on the 30th day and 180th day postoperatively. Preoperative Visual Analogue Scale score for plantar hyperhidrosis was 9.54 ± 0.66 that following sympathectomy decreased to 2.27 ± 1.67 on the seventh postoperative day. However, slight insignificant increase was noted to become 2.73 ± 1.65 on the 30th day and 6th month postoperatively. Compensatory hyperhidrosis was recorded in 3.9% of patients at 6th month postoperatively. Conclusion Palmar hyperhidrosis is usually associated with plantar hyperhidrosis. Thoracoscopic sympathectomy is an effective and safe treatment for palmar hyperhidrosis. It may completely or partially cure plantar hyperhidrosis.

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Efficacy and Safety of Radiofrequency Ablation Versus Video-assisted Thoracoscopic Sympathectomy in Palmar Hyperhidrosis: A Multicenter Cohort Study

10.21203/rs.3.rs-818858/v1 ◽

2021 ◽

Author(s):

Yiyue Zhong ◽

Yanwen Zhu ◽

Jiayan Li ◽

Xiaowei Yang ◽

Zhiying Feng ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Complete Remission ◽

Clinical Efficacy ◽

Treatment Options ◽

Palmar Hyperhidrosis ◽

Related Complication ◽

Multicenter Cohort Study ◽

Thoracoscopic Sympathectomy ◽

Video Assisted ◽

Lower Success Rate

Abstract Background: Radiofrequency ablation (RFA) was adopted as an alternative to surgical options for sympathectomy in patients with palmar hyperhidrosis (PHH), but the RFA comparative efficacy of treatments by video-assisted thoracoscopic sympathectomy (VATS) on long-term remains uncertain.Methods: We recruited patients aged ≥14 years with diagnosed PHH from 14 centers in China. The treatment options of RFA or VATS were recruited in patient with informed consent. The primary outcome was the clinical efficacy in 1-year. Propensity scoring and multivariable models respectively were used to evaluate the clinical efficacy and inefficacy risk of treatment options.Results: A total of 807 patients were enrolled, 351 patients underwent RFA, and 456 were VATS. After propensity score matching, the rate of complete remission was lower in RFA than in VATS (79.2% [247/312] versus 91.3% [285/312], 95% confidence intervals [CI] 0.21 to 0.57, p<0.001). However, the rate of palmar dryness (95% CI 0.38 to 0.92, p=0.020), of postoperative pain (95% CI 0.13 to 0.33, p<0.001), and of surgical-related complication (95% CI 0.19 to 0.85, p=0.020) is lower in RFA group than in VATS group, and radiofrequency ablation group of skin temperature rise is more common (95% CI 1.84 to 3.58, p<0.001).Conclusion: Performing RFA had a lower success rate than VATS for the complete remission of palmar hyperhidrosis. However, RFA may be better reasonable treatment option for palmar hyperhidrosis before surgical sympathectomy, because it more possibly accepted and generalized due to lower symptomatic burden and costs than surgical sympathectomy in patients.Trial RegistrationChiCTR2000039576, URL: http://www.chictr.org.cn/index.aspx

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Role of video-assisted thoracoscopic sympathectomy in the treatment of primary hyperhidrosis

Sao Paulo Medical Journal ◽

10.1590/s1516-31802003000500003 ◽

2003 ◽

Vol 121 (5) ◽

pp. 191-197 ◽

Cited By ~ 24

Author(s):

Luiz Eduardo Villaça Leão ◽

Renato de Oliveira ◽

Renuzza Szulc ◽

Jair de Jesus Mari ◽

Pedro Luis Reis Crotti ◽

...

Keyword(s):

Clinical Course ◽

Life Assessment ◽

Palmar Hyperhidrosis ◽

Compensatory Sweating ◽

Axillary Hyperhidrosis ◽

Thoracoscopic Sympathectomy ◽

Thoracic Sympathectomy ◽

Video Assisted ◽

Phone Calls ◽

The Impact

CONTEXT: Essential hyperhidrosis is a frequent disorder causing significant functional impairment. The advent and development of video-assisted thoracoscopic techniques now allows thoracic sympathectomy to be carried out precisely and safety with good results and minimal morbidity. OBJECTIVE: To assess the impact of video-assisted thoracic sympathectomy in patients diagnosed as presenting severe and disabling hyperhidrosis. TYPE OF STUDY: This was a longitudinal study of the clinical course of all hyperhidrosis cases selected for surgery between May 1999 and January 2003. SETTING: Division of Thoracic Surgery, Universidade Federal de São Paulo (UNIFESP). PARTICIPANTS: 743 patients with surgery indicated due to palmar hyperhidrosis (49.8%), palmar-axillary hyperhidrosis (38.1%), craniofacial hyperhidrosis (8.9%) or isolated axillary hyperhidrosis (2.8%). PROCEDURES: Video-thoracoscopic sympathectomy was performed, isolating the second thoracic ganglion (T2) in all patients, with additional sympathectomy of T3 and T4 if necessary. MAIN MEASUREMENTS:The clinical course was followed up via questionnaires, phone calls, letters and statements. Simple questions were asked regarding the disappearance of symptoms and presence and intensity of compensatory sweating. RESULTS: The surgery was regarded as efficient in all cases of palmar hyperhidrosis. In the craniofacial hyperhidrosis cases, partial recurrence of the symptoms occurred in 2 cases (3.0%). Partial recurrence or persistence of symptoms occurred in 20% of the patients with predominantly axillary symptomatology. The compensatory sweating was considered disagreeable or uncomfortable by about 30% of the patients, but it only reached the level of regretting the operation for 3% of them. This occurred more frequently in patients with axillary hyperhidrosis. Ten cases of complications occurred. CONCLUSION: Thoracoscopic sympathectomy provides very good results in most patients, with a very low complication rate. However, the assessment of surgical results using conventional methods is imprecise and inaccurate. Different methodology, including quality of life assessment, must be used for comparing results and providing objective data on the results of this operation.

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Video-Assisted Thoracoscopic Sympathectomy for Palmar Hyperhidrosis: A Meta-Analysis of Randomized Controlled Trials

PLoS ONE ◽

10.1371/journal.pone.0155184 ◽

2016 ◽

Vol 11 (5) ◽

pp. e0155184 ◽

Cited By ~ 5

Author(s):

Wenxiong Zhang ◽

Dongliang Yu ◽

Han Jiang ◽

Jianjun Xu ◽

Yiping Wei

Keyword(s):

Randomized Controlled Trials ◽

Meta Analysis ◽

Palmar Hyperhidrosis ◽

Controlled Trials ◽

Thoracoscopic Sympathectomy ◽

Randomized Controlled ◽

Video Assisted

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The Effect of T3 versus T4 Thoracoscopic Sympathectomy on Hyperhidrosis

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1430976 ◽

2021 ◽

pp. 101-110

Author(s):

Karim Mohamed El Mesery ◽

Ahmed Emadeldeen Ghoneim ◽

Abd Elhady Mohamed Taha ◽

Mohamed Mahmoud Abo Elnasr

Keyword(s):

Postoperative Complications ◽

Treatment Success ◽

Palmar Hyperhidrosis ◽

Surgical Approaches ◽

Compensatory Hyperhidrosis ◽

Thoracoscopic Sympathectomy ◽

Video Assisted ◽

Significant Difference ◽

Primary Hyperhidrosis

Background: Primary hyperhidrosis is a disorder characterized by excessive sweating. However, surgical therapy is the most effective treatment for patients with primary hyperhidrosis. In between all different surgical approaches, video assisted thoracoscopic surgery (VATS) sympathectomy has been considered as a safe and minimally invasive procedure for palmer and axillary hyperhidrosis. The aim of this study was to evaluate the effectiveness of T3 vs. T4 sympathectomy regarding postoperative complications, recurrence and compensatory hyperhidrosis (CH) on 6 months follow up. Methods: This prospective randomized study was conducted over 20 patients undergoing VATS sympathectomy diagnosed with palmar hyperhidrosis and failed medical treatment and undergoing thoracoscopic sympathectomy. Patients were divided randomly into two groups; group A (T3 sympathectomy) and group B (T4 sympathectomy). Results: There was no significant difference between the two groups regarding the degree of treatment success, compensatory hyperhidrosis after one month and after 6 months. There was non-significant difference between the two groups regarding the recurrence, late postoperative complications and satisfaction. Conclusions: Video-assisted T3 or T4 sympathectomy is a safe and effective procedure for treatment of palmar hyperhidrosis and T3 or T4 sympathectomy had no difference regarding to dryness and Compensatory Hyperhidrosis in follow-up for 6 months. Both techniques were effective for treating palmar hyperhidrosis with high rates of success and no recurrence for 6 months.

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