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.

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.

Endoscopic thoracic sympathectomy for primary hyperhidrosis: A 16-year follow up in a single UK centre

The Surgeon ◽  
2013 ◽  
Vol 11 (3) ◽  
pp. 130-133 ◽  
Author(s):  
Alan Askari ◽  
Ali Kordzadeh ◽  
Gui Han Lee ◽  
Michael Harvey
Keyword(s):  
Endoscopic Thoracic Sympathectomy ◽  
Thoracic Sympathectomy ◽  
Primary Hyperhidrosis

Endoscopic thoracic sympathectomy for primary hyperhidrosis: A 16-year follow up in a single UK centre

The Surgeon ◽  
2014 ◽  
Vol 12 (1) ◽  
pp. 59
Author(s):  
A.E.P. Cameron ◽  
C.P. Connery ◽  
J.R.M. De Campos ◽  
M. Hashmonai ◽  
P.B. Licht ◽  
...  
Keyword(s):  
Endoscopic Thoracic Sympathectomy ◽  
Thoracic Sympathectomy ◽  
Primary Hyperhidrosis

scholarly journals Longitudinal follow-up of cardiac vagal activity in individuals undergoing endoscopic thoracic sympathectomy

2018 ◽  
Vol 44 (6) ◽  
pp. 456-460
Author(s):  
Ana Paula Ferreira ◽  
Plinio dos Santos Ramos ◽  
Jorge Montessi ◽  
Flávia Duarte Montessi ◽  
Eveline Montessi Nicolini ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Exercise Test ◽  
Vagal Activity ◽  
Endoscopic Thoracic Sympathectomy ◽  
Thoracic Sympathectomy ◽  
Time Points ◽  
Longitudinal Investigation ◽  
Primary Hyperhidrosis ◽  
The Mean

ABSTRACT Objective: To conduct a longitudinal investigation of cardiac vagal activity (CVA) by measuring resting HR and calculating the cardiac vagal index (CVI) in individuals undergoing sympathectomy for the treatment of primary hyperhidrosis. Methods: This was a descriptive longitudinal study involving 22 patients, 13 of whom were female. The mean age was 22.5 ± 8.8 years. The palms, soles, and axillae were the most commonly affected sites. Resting HR was measured by an electrocardiogram performed 20 min before the 4-second exercise test (4sET), which was used in order to evaluate CVA at three different time points: before surgery, one month after surgery, and four years after surgery. Results: Resting HR (expressed as mean ± SE) was found to have decreased significantly at 1 month after surgery (73.1 ± 1.6 bpm before surgery vs. 69.7 ± 1.2 bpm at one month after surgery; p = 0.01). However, the HR values obtained at four years after surgery tended to be similar to those obtained before surgery (p = 0.31). The CVI (expressed as mean ± SE) was found to have increased significantly at one month after surgery (1.44 ± 0.04 before surgery vs. 1.53 ± 0.03 at one month after surgery; p = 0.02). However, the CVI obtained at four years after surgery tended to be similar to that obtained before surgery (p = 0.10). Conclusions: At one month after sympathectomy for primary hyperhidrosis, patients present with changes in resting HR and CVA, both of which tend to return to baseline at four years after surgery.

scholarly journals Does endoscopic thoracic sympathectomy improve the quality of life of patients with primary hyperhidrosis? A single center retrospective review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 43
Author(s):  
Ahmad Farouk Musa ◽  
Khit Kar Hui ◽  
Jeswant Dillon ◽  
Rusli Bin Nordin
Keyword(s):  
Quality Of Life ◽  
Retrospective Review ◽  
Medical Records ◽  
Endoscopic Thoracic Sympathectomy ◽  
Thoracic Sympathectomy ◽  
Symptom Resolution ◽  
Primary Hyperhidrosis ◽  
Heart Center

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.

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.  

Sign in / Sign up

Export Citation Format

Share Document