Compensatory Hyperhidrosis after Endoscopic Thoracic Sympathectomy for Primary Hyperhidrosis-predisposing Factors and Impact on Patient Satisfaction

Neurosurgery ◽  
2005 ◽  
Vol 57 (2) ◽  
pp. 423-423
Author(s):  
Noel I. Perin ◽  
Ignacio J. Barrenechea
Keyword(s):  
Patient Satisfaction ◽  
Predisposing Factors ◽  
Endoscopic Thoracic Sympathectomy ◽  
Compensatory Hyperhidrosis ◽  
Thoracic Sympathectomy ◽  
Primary Hyperhidrosis

IMPACT OF COMPENSATORY HYPERHIDROSIS ON PATIENT SATISFACTION AFTER ENDOSCOPIC THORACIC SYMPATHECTOMY

Neurosurgery ◽  
2009 ◽  
Vol 64 (3) ◽  
pp. 511-518 ◽  
Author(s):  
Mark Chwajol ◽  
Ignacio J. Barrenechea ◽  
Shamik Chakraborty ◽  
Jonathan B. Lesser ◽  
Cliff P. Connery ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Retrospective Chart Review ◽  
Definitive Treatment ◽  
P Value ◽  
Endoscopic Thoracic Sympathectomy ◽  
Compensatory Hyperhidrosis ◽  
Thoracic Sympathectomy ◽  
Level Of Satisfaction ◽  
Focal Hyperhidrosis ◽  
The Impact

Abstract OBJECTIVE Endoscopic thoracic sympathectomy (ETS) remains the definitive treatment for primary focal hyperhidrosis. Compensatory hyperhidrosis (CH) is a significant drawback of ETS. We sought to identify the predictors for the development of severe CH after ETS, its anatomic locations, and its frequency of occurrence, and we analyzed the impact of CH on patient satisfaction with ETS. METHODS Bilateral ETS for primary focal hyperhidrosis was performed in 220 patients, and a retrospective chart review was conducted. Follow-up evaluation was conducted using a telephone questionnaire, and 73% of all patients were contacted. Patients' responses regarding CH and their level of satisfaction after ETS were analyzed. Statistical analysis was performed using SPSS software (Version 14.0; SPSS, Inc., Chicago, IL). A P value of <0.05 was considered statistically significant. RESULTS Some degree of CH developed in 94% of patients. The number of levels treated was not related to the occurrence of severe CH. Isolated T3 ganglionectomy led to a significantly lower incidence of severe CH, when compared with all other levels (P < 0.03). Ninety percent of patients were satisfied with the procedure. The development of severe CH, as opposed to mild or moderate CH, significantly correlated with a lower satisfaction rate (P = 0.003). CONCLUSION CH is common after ETS procedures, and the occurrence of severe, but not mild or moderate, CH is a major source of dissatisfaction after ETS. The overall occurrence of severe CH is reduced after T3 ganglionectomy as opposed to ganglionectomies performed at all other levels. The level of satisfaction with ETS is high.

scholarly journals Long-Term Effect of Endoscopic Sympathetic Nerve Reconstruction for Side Effects after Endoscopic Sympathectomy

2016 ◽  
Vol 65 (06) ◽  
pp. 484-490 ◽  
Author(s):  
Timo Telaranta ◽  
Tuomo Rantanen
Keyword(s):  
Side Effects ◽  
Sympathetic Nerve ◽  
Nerve Reconstruction ◽  
Endoscopic Thoracic Sympathectomy ◽  
Thoracic Sympathectomy ◽  
Long Term Effect ◽  
Primary Hyperhidrosis ◽  
The Mean

Background Endoscopic thoracic sympathectomy (ETS) is an effective treatment for primary hyperhidrosis. However, compensatory sweating (CS) may occur in many patients. Sympathetic nerve reconstruction (SNR) can be used to counteract severe CS, but the studies on the effects of SNR are few. Patients and Methods Nineteen out of 150 SNR patients were contacted by employing a long-term questionnaire. In this questionnaire, different kinds of sweating were evaluated using a four-graded symptom analysis and the visual analog scale before ETS, after ETS, and after SNR. Results The mean age of the 16 male and 3 female patients at the SNR was 32 years. The mean follow-up was 87 months. According to the long-term questionnaire, the benefit was either excellent (4 patients, 21%), good (3 patients, 15.8%), or reasonable (7 patients, 36.8%) in 14 patients (73.8%), while the benefit was questionable in 1 patient (5.3%). For three patients (15.8%), no benefit was found, and in one patient (5.3%), the situation had deteriorated. Conclusions Improvement in the side effects of ETS after SNR was found in nearly 75% of the patients. This indicates that SNR can be considered as an alternative treatment for patients with severe CS after ETS that is unresponsive to conservative treatment.

scholarly journals A retrospective review on minimally invasive technique via endoscopic thoracic sympathectomy (ETS) in the treatment of severe primary hyperhidrosis: Experiences from the National Heart Institute, Malaysia

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 670
Author(s):  
Ahmad Farouk Musa ◽  
Vignaa Prashanth Gandhi ◽  
Jeswant Dillon ◽  
Rusli Bin Nordin
Keyword(s):  
Sweat Glands ◽  
Invasive Technique ◽  
Moderate Degree ◽  
Endoscopic Thoracic Sympathectomy ◽  
Thoracic Sympathectomy ◽  
Primary Hyperhidrosis ◽  
Response To Stress ◽  
Pertinent Information

Background: Hyperhidrosis is due to the hyperactive autonomic stimulation of the sweat glands in response to stress. Primary hyperhidrosis is a common yet psychologically disabling condition. This study will describe our experience in managing hyperhidrosis via endoscopic thoracic sympathectomy (ETS). Methods: The information was obtained from the patient records from 1st January 2011 until 31st December 2016. Pertinent information was extracted and keyed into a study proforma. Results:  150 patients were operated on but only 118 patients were included in this study. The mean age was 22.9±7.3 years. The majority (54.2%) had palmar-plantar hyperhidrosis and 39.8% had associated axillary hyperhidrosis. Excision of the sympathetic nerve chain and ganglia were the main surgical technique with the majority (55.9%) at T2-T3 level. Mean ETS procedure time was 46.6±14.29 minutes with no conversion. Surgical complications were minimal and no Horner’s Syndrome reported. Mean hospital stay was 3.5±1.05 days. The majority of patients (67.8%) had only one follow-up and only half of the study sample (58.5%) complained mild to moderate degree of compensatory sweating, even though the long-term resolution is yet to be determined by another study. Following ETS, 98.3% of patients had instant relief and resolved their palmar hyperhidrosis. Predictors of CS were sympathectomy level and follow-up. The odds of reporting CS was 2.87 times in patients undergoing ETS at the T2-T3 level compared to those undergoing ETS at the T2-T4 level. The odds of reporting CS was 13.56 times in patients having more than one follow-up compared to those having only one follow-up. Conclusion: We conclude that ETS is a safe, effective and aesthetically remarkable procedure for the treatment of primary hyperhidrosis  with only half of the patients developing mild to moderate degree of CS. Significant predictors of CS were sympathectomy level during ETS and frequency of follow-up after ETS.

Endoscopic Thoracic sympathectomy for Primary Palmar hyperhidrosis

2020 ◽  
Vol 17 (1) ◽  
pp. 59-62
Author(s):  
Rupesh Chakradhar ◽  
Amit Thapa
Keyword(s):  
Negative Impact ◽  
Botulinum Toxin Injection ◽  
Endoscopic Thoracic Sympathectomy ◽  
Medical Treatments ◽  
Thoracic Sympathectomy ◽  
Minimally Invasive Surgical ◽  
Post Operative Period ◽  
Primary Hyperhidrosis ◽  
Surgical Modality

Primary hyperhidrosis is a disorder in which there is an excessive amount of sweating more than required for the body’s thermoregulation. It is due to excessive function of the sudomotor sweat control system in the absence of a sweating trigger. We had a 25-year-old engineer, who presented with complaints of profuse sweating in both his palms, feet and axillae for more than 10 years. He had distressing symptoms disabling his daily activities and causing negative impact in his social, professional, recreational and quality of life. He took medical treatments including topical agents, anticholinergics, iontophoresis and even botulinum toxin injection. All these not only failed to give relief but only aggravated his disappointment. Endoscopic thoracic bilateral sympathectomy was performed from T2 to T4 level. Drastic improvement was seen in immediate post-operative period. Pre-operative palmar temperature of 90° Fahrenheit increased to 96.5° Fahrenheit in immediate post-operative period. His post-operative period was uneventful and was discharged on the second postoperative day. On follow-up after 30 days, the patient was asymptomatic, fully satisfied with the surgery and without any complications. Endoscopic thoracic sympathectomy is a safe, effective, fast and minimally invasive surgical modality of treatment for primary hyperhidrosis.  

Chronological changes of postsympathectomy compensatory hyperhidrosis and recurrent sweating in patients with palmar hyperhidrosis

2005 ◽  
Vol 2 (2) ◽  
pp. 151-154 ◽  
Author(s):  
Thomas S. M. Chiou
Keyword(s):  
Patient Satisfaction ◽  
Palmar Hyperhidrosis ◽  
Analog Scale ◽  
Compensatory Hyperhidrosis ◽  
Content Type ◽  
Thoracic Sympathectomy ◽  
The Mean ◽  
Upper Thoracic ◽  
Fine Print

Object. The author sought to investigate the temporal changes of postsympathectomy compensatory hyperhidrosis and recurrent sweating in patients with primary palmar hyperhidrosis. Methods. The author examined 91 consecutive patients for this prospective 6-year study. The patients were interviewed at least twice during a 6-month interval; the first follow up was conducted at a median of 1.7 years after surgery (range 2.5–60.5 months). Overall, 24 patients (26.4%) were followed for more than 2 years. Attention was focused on patient satisfaction and the incidence of compensatory hyperhidrosis and recurrent sweating. The overall mean patient satisfaction rate was 78%, with a median 80% improvement on a visual analog scale from 0% (poor) to 100% (excellent). Overall, 88 patients (96.7%) developed compensatory hyperhidrosis, with the mean initial occurrence at 8.2 weeks. The symptoms of compensatory hyperhidrosis progressively worsened to the maximum degree within another 2 weeks after onset (mean 10.3 ± 1.83 weeks). In 19 patients (21.6%), symptoms of compensatory hyperhidrosis improved spontaneously within 3 months after sympathectomy (mean 13.3 weeks). Postoperative compensatory hyperhidrosis occurred in 71.4% of patients within the 1st year. Recurrent sweating occurred in only 17.6% of patients. None of these patients required repeated operation. The earliest onset of recurrent sweating was noted at 2 weeks postoperatively by three patients, and the mean initial postoperative reccurrence was 32.7 weeks after surgery. Conclusions. Compensatory hyperhidrosis and recurrent sweating are normal thermoregulatory responses that occurred after upper thoracic sympathectomy. Compensatory hyperhidrosis was more prevalent and developed earlier than recurrent sweating. The severity of both compensatory hyperhidrosis and recurrent sweating symptoms remained stable 6 months after surgery.

scholarly journals Is age group a predictive factor for satisfaction among patients undergoing sympathectomy to treat hyperhidrosis?

2011 ◽  
Vol 10 (4) ◽  
pp. 284-288 ◽  
Author(s):  
José Ribas Milanez de Campos ◽  
Nelson Wolosker ◽  
Marco Antonio Soares Munia ◽  
Guilherme Yazbek ◽  
Paulo Kauffman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Body Mass ◽  
Age Groups ◽  
Age Group ◽  
Compensatory Hyperhidrosis ◽  
Thoracic Sympathectomy ◽  
Video Assisted ◽  
Primary Hyperhidrosis

OBJECTIVE: Video-assisted thoracic sympathectomy is currently the procedure of choice for the definitive treatment of primary hyperhidrosis, because it is an effective, safe, and minimally invasive method. In the search for better quality of life indexes, all researchers look for predictive factors indicating better surgical outcomes. Failure in the primary treatment, postoperative compensatory hyperhidrosis, body mass index over 25, level of resection of the sympathetic chain, and extent of resection are some of the factors that may negatively influence the results. The objective of this study was to compare, according to the age group, the quality of life after bilateral thoracic sympathectomy for treatment of primary hyperhidrosis in a cohort of 1,644 patients. METHODS: From February 2000 to October 2008, data were collected from 1,644 patients with palmar (71%) or axillary (29%) hyperhidrosis who underwent video-assisted thoracic sympathectomy. The patients were divided into three groups according to their ages. The first group consisted of patients up to 17 years-old, the second from 18 to 30 years-old, and the third of over 30 years-old. All patients had a body mass index of less than 25. RESULTS: In the evaluation 30 days after surgery, improvement of the quality of life in the three groups was observed. There was no significant difference between the age groups. In the present study, 91.9% of the patients presented compensatory hyperhidrosis, with no difference between the age groups. CONCLUSIONS: Patients with primary hyperhidrosis experience quality of life improvement after thoracic sympathectomy regardless of their age.

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