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

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.

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.


2020 ◽  
Vol 17 (1) ◽  
pp. 59-62
Author(s):  
Rupesh Chakradhar ◽  
Amit Thapa

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.  


2011 ◽  
Vol 10 (4) ◽  
pp. 284-288 ◽  
Author(s):  
José Ribas Milanez de Campos ◽  
Nelson Wolosker ◽  
Marco Antonio Soares Munia ◽  
Guilherme Yazbek ◽  
Paulo Kauffman ◽  
...  

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.


2016 ◽  
Vol 43 (6) ◽  
pp. 486-492 ◽  
Author(s):  
GILMAR FELISBERTO JÚNIOR ◽  
CLÁUDIO JOSÉ RUBIRA ◽  
JOÃO PAULO SANCHES BERUMUDES ◽  
SALUM BUENO DA-SILVEIRA-JÚNIOR

ABSTRACT Primary hyperhidrosis (PH) is a condition that has a great impact on affected individuals' quality of life, regardless of its location. Its surgical treatment is done through thoracic sympathectomy performed by videothoracoscopy. Standardization of the technique includes section of the sympathetic trunk at different levels, according to the site of symptoms. The aim of this review is to evaluate the efficacy of thoracic sympathectomy through a systematic literature review comparing sympathectomy at different levels of the sympathetic chain.


2019 ◽  
Vol 8 (3) ◽  
pp. 130-135
Author(s):  
L. N. Igisheva ◽  
A. A. Anikeenko ◽  
R. A. Kornelyuk ◽  
М. V. Kulavskaya ◽  
N. G. Perevalova

Medical records of a patient presented with severe aortic and mitral regurgitation and connective tissue dysplasia were reviewed. Clinical, laboratory and instrumental findings were collected at baseline and after the surgery. Long-term outcomes, including quality of life, were estimated.


Author(s):  
Micheli Fortunato Domingos ◽  
Julio Cezar Uili Coelho ◽  
Isabel Roldo Nogueira ◽  
Mônica Beatriz Parolin ◽  
Jorge Eduardo Fouto Matias ◽  
...  

Aim: This study goal was to evaluate the long-term quality of life of patients who underwent cadaveric liver transplants (CLT) in two Brazilian hospitals. Methods: Medical records of all patients who underwent CLT and survived over 10 years were revised. The international validated questionnaire Short-Form 36 was employed to assess the quality of life. Patients data were obtained from electronic medical records and study protocols. Results: A total of 342 patients underwent CLT, of which 129 were alive and 93 fully answered the questionnaire and were included in the study. The group consisted of 62 men (66.6%) and 31 women (33.4%), with average age of 40.1±15.9 years. Follow-up time was 16±4.1 years. The most common indication of CLT was hepatic cirrhosis caused by hepatitis C virus, 24.7%. Transplanted patients had lower scores than the general population in mental health [62.9 (95%CI: 60.1-65.7,) vs. 74.5, p < 0.001]. In all other domains, transplanted patients had similar (emotional aspect limitiation, pain, and general health status) or superior (physical aspect limitation, social aspects, functional capacity, and vitality) scores than the general population. Functional capacity score was lower in patients with long-term complications, who were aged more than 50-years, and unemployed. Conclusions: The quality of life in patients with more than 10 years after CLT was similar or superior than the general population, except for the mental health domain.


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