scholarly journals Endoscopic Thoracic Sympathectomy for Primary Hyperhidrosis of the Upper Limbs A Critical Analysis and Long-Term Results of 480 Operations

1994 ◽  
Vol 220 (1) ◽  
pp. 86-90 ◽  
Author(s):  
F. Herbst ◽  
E. G. Plas ◽  
R. Függer ◽  
A. Fritsch
2016 ◽  
Vol 65 (06) ◽  
pp. 484-490 ◽  
Author(s):  
Timo Telaranta ◽  
Tuomo Rantanen

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.


F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 670
Author(s):  
Ahmad Farouk Musa ◽  
Vignaa Prashanth Gandhi ◽  
Jeswant Dillon ◽  
Rusli Bin Nordin

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.


2003 ◽  
Vol 75 (4) ◽  
pp. 1075-1079 ◽  
Author(s):  
Dominique Gossot ◽  
Domenico Galetta ◽  
Antoine Pascal ◽  
Denis Debrosse ◽  
Raffaele Caliandro ◽  
...  

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 43
Author(s):  
Ahmad Farouk Musa ◽  
Khit Kar Hui ◽  
Jeswant Dillon ◽  
Rusli Bin Nordin

Background: Endoscopic thoracic sympathectomy (ETS) is renowned as an effective surgical treatment for primary hyperhidrosis (PHH) and believed to improve patients’ quality of life (QOL). This study aimed to evaluate the quality of life (QOL) of patients with PHH after ETS compared to before ETS, and to determine whether compensatory sweating (CS) affects QOL of patients. Methods: This is a single-centre retrospective review of patients who had undergone ETS at the National Heart Center [Institut Jantung Negara (IJN)], Malaysia. In total, 62 patients from January 2014 to December 2018 were recruited. Medical records were first reviewed for all relevant data, prior to making telephone interview to administer the questionnaire. A modified questionnaire with validated components was used to assess the patients’ QOL. Patient satisfaction, symptom resolution, recurrence and occurrence of CS were also asked during the interview. Data were analysed using IBM  SPSS Statistics 25.0. Results: A total of 46 patients (response rate: 74.2%) completed the questionnaire, with 95.7% reporting improvement in the total QOL score (Mean difference = 113.54, SD=70.79, 95% CI = 95.52 – 134.57, p<0.001). There was remarkable symptom resolution for palmar HH as 97.8% reported dry hands, whereas majority of patients with palmar-plantar HH reported persistent sweating from feet HH. CS rate was 89.1%.  In terms of severity of CS, 6 (14.6%) reported mild, 17 (41.5%) moderate, and 18 (43.9%) had severe CS. The severity of CS as well as the number of locations have a significant effect on the QOL reported (p=0.022 and p=0.008, respectively). Conclusion: ETS is an effective treatment for PHH in improving the QOL of patients, even long term. The occurrence of CS did not affect the QOL, but severity of CS and number of locations involved in CS affect the QOL of patients.


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