Thoracoscopic sympathectomy for treatment of primary hyperhidrosis in children: a randomized comparative study between clipping and electrocautery techniques

ABSTRACT Objective: to compare the intensity of reflex sweating with the degree of anxiety and its interference in the quality of life of patients undergoing Thoracoscopic (VATS) sympathectomy in the pre- and postoperative period. Methods: we evaluated 54 patients with a mean age of 26 years (16-49 years) undergoing sympathectomy in the R3-R4 level. We applied two questionnaires at three different times: "Quality of life in patients with primary hyperhidrosis" and "Scale for anxiety and depression". Results: of the patients studied, 93% showed significant improvement in quality of life 30 days after surgery, the effects remaining after six months. There were no postoperative complications. The patient's level of anxiety is highly correlated with the intensity of reflex sweating after 30 and 180 days. Conclusion: Thoracoscopic sympathectomy improves quality of life of patients with primary hyperhidrosis, even with the emergence of reflex sweating. Anxiety directly relates to the intensity of reflex sweating, without compromising the degree of patient satisfaction.

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Infraareolar access for thoracoscopic sympathectomy to treat primary hyperhidrosis

Surgery Today ◽

10.1007/s00595-012-0214-9 ◽

2012 ◽

Vol 43 (2) ◽

pp. 221-224 ◽

Cited By ~ 1

Author(s):

Sônia Oliveira Lima ◽

Yasmin Gama Abuawad ◽

Paulo Sérgio Faro Santos ◽

Aloisio Ferreira Pinto Neto ◽

Vanessa Rocha de Santana ◽

...

Keyword(s):

Thoracoscopic Sympathectomy ◽

Primary Hyperhidrosis

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Evaluation of quality of life in patients after thoracoscopic sympathectomy for primary hyperhidrosis

Hellenic Journal of Surgery ◽

10.1007/s13126-011-0023-4 ◽

2011 ◽

Vol 83 (3) ◽

pp. 170-174

Author(s):

J. Hartmann ◽

S. Limmer ◽

Ch. Menenakos ◽

B. Ablassmaier

Keyword(s):

Quality Of Life ◽

Thoracoscopic Sympathectomy ◽

Primary Hyperhidrosis

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Videothoracoscopic sympathectomy - a standard treatment for primary hyperhidrosis at the Clinic of Thoracic Surgery in Sremska Kamenica / Videotorakoskopska simpatektomija – standarna hirurška metoda za lečenje primarne hiperhidroze na Klinici za grudnu hirurgiju u Sremskoj Kamenici

Serbian Journal of Dermatology and Venerology ◽

10.2478/v10249-011-0025-9 ◽

2010 ◽

Vol 2 (3) ◽

pp. 85-94

Author(s):

Ivan Kuhajda ◽

Miloš Koledin ◽

Dejan Đurić ◽

Milorad Bijelović ◽

Mišel Milošević ◽

...

Keyword(s):

Quality Of Life ◽

Conservative Therapy ◽

Standard Treatment ◽

Long Term Results ◽

Compensatory Sweating ◽

Thoracoscopic Sympathectomy ◽

Perioperative Morbidity ◽

Primary Hyperhidrosis ◽

Epidemiological Characteristics

AbstractPrimary hyperhidrosis affects approximately 3% of the world’s population, particularly young female adults. It is defined as excessive, profuse sweating of the palms, soles, armpits and face. Conservative treament includes diverse modalities, however, surgical treatment has shown the best long-term results. The objective of this study was to assess some disease-specific epidemiological characteristics in a pre-selected group of patients seeking surgical therapy, as well as outcomes of thoracoscopic sympathectomy. The severity and impact of hypehidrosis was assessed, using Hyperhidrosis Disease Severity Scale (HDSS: patients rate the serverity of symptoms on a scale from 1 to 4). Thoracoscopic sympathectomy was performed using a double lumen endotracheal tube, via bilateral 5 mm dual port videothoracoscopic camera 0°, and an endoscopic ultrasound activated harmonic scalpel. The sympathetic chain was resected on both sides at the level of the second and the third thoracic ganglion (T2 and T3), using an ultrasound knife. The extirpated chain was also at the level T3-T4 and sent forex temporeanalysis.There were 162 patients undergoing thoracoscopic sympathectomy: 39.51% were males and 60.49% females; at presentation their mean age (± SD) was 30.5 (±8.3), range 16 - 58 years. Axillary hyperhidrosis occurs later than palmar-axillary-plantar (p<0.05). A total of 35.18% of the evaluated patients were able to name at least one member of their families who also suffered from hyperhidrosis. The most commonly affected area was palmar-axillary-plantar (30.25%). Fifty patients (30.86%) received conservative therapy before surgery. The most commonly used conservative therapy modalities included different kinds of ointments/tinctures (11.73%), botox (8.02%) and iontophoresis (2.47%). Prior to surgery, 91.36% of patients reported severe sweating (HDSS score 3 or 4). The highest mean score was given for a combination of facial-palmar-axillaryplantar hyperhidrosis (3.80±0.24). All surgeries were successfully performed, with no complications, or perioperative morbidity. The mean hospital stay was 1.28±0.68 days long. After surgery, 93.21% of patients reported mild or moderate hyperhidrosis (HDSS score 1 or 2). Compensatory sweating (lower part of the back, and abdomen) was reported by 34.57% of patients after the surgery. All patients had a 6-months long follow-up: a significant improvement in quality of life was reported by 84.56% of patients (Yates corrected c2 (1) = 228.42; p=0.0000)); due to compensatory sweating, only 4.94% and 1.85% of patients reported bad and very bad quality of life, respectively.In conclusion, nowadays videothoracoscopic sympathectomy is a standard treatment for primary hyperhidrosis with a high success rate.

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The Rate of Compensatory Sweating and Clinical Outcomes of Selective Thoracoscopic Sympathectomy (Ramicotomy) in Patients with Primary Palmar Hyperhidrosis

Archives of Neuroscience ◽

10.5812/ans.111026 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Karamollah Toolabi ◽

Siavash Khaki ◽

Ehsan Sadeghian ◽

Narges Lamsehchi ◽

Fezzeh Elyasinia

Keyword(s):

Clinical Outcomes ◽

Palmar Hyperhidrosis ◽

Compensatory Sweating ◽

Thoracoscopic Sympathectomy ◽

Lower Back ◽

Term Adverse Effect ◽

Significant Difference ◽

Primary Hyperhidrosis ◽

High Level

Background: Primary hyperhidrosis is a sympathetic disorder characterized by prolonged and uncontrollable sweating. It is associated with emotional stress or psychological causes that preferably affects the axillae, palms, feet, and face. Video-assisted thoracoscopic sympathetic surgery is currently a globally recognized treatment for primary palmar hyperhidrosis (PH). However, compensatory sweating (CS) is the most prominent long-term adverse effect of thoracoscopic sympathectomy. Objectives: Here, we aim to perform selective sympathetic ramicotomy for primary palmar hyperhidrosis patients and evaluate the clinical outcomes of satisfaction, as well as the effect on the frequency, location, and severity of compensatory sweating. Methods: In this single-arm trial study, 24 sympathectomies were carried out on 12 patients with primary palmar hyperhidrosis who were candidates for bilateral thoracoscopic selective sympathectomy (ramicotomy) at Imam Khomeini Hospital. The patients’ demographic information was interviewed and followed up using telephone questionnaires in the health center one week after surgery. Then, the rates of compensatory sweating, satisfaction, and failure or recurrence were retrospectively analyzed. Results: No significant differences were observed between age, gender, weight, BMI, and compensatory sweating rates. Notwithstanding, there was a statistically significant difference in the severity of compensatory sweating with patients’ height (P = 0.016). Compensatory sweating occurred in 66.7% of the patients; 50% of the patients were mild, 16.7% of the patients were moderate, and there was no intolerable compensatory sweating or recurrence. The most incidence of compensatory sweating was on the lower back. The rate of satisfaction was 94.5 ± 7.8%. Conclusions: Selective thoracoscopic sympathectomy (ramicotomy) is an effective surgical procedure with a very high level of precision and satisfaction. This technique hence should be considered the method of choice for the treatment of primary palmar hyperhidrosis.

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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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Evaluation of quality of life before and after videothoracoscopic simpathectomy for primary hyperhidrosis

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912014005005 ◽

2014 ◽

Vol 41 (5) ◽

pp. 325-330 ◽

Cited By ~ 6

Author(s):

João Batista Baroncello ◽

Layla Regina Zambenedetti Baroncello ◽

Emílio Gabriel Ferro Schneider ◽

Guilherme Garcia Martins

Keyword(s):

Quality Of Life ◽

Average Quality ◽

Axillary Hyperhidrosis ◽

Cross Sectional ◽

Compensatory Hyperhidrosis ◽

Thoracoscopic Sympathectomy ◽

Before And After ◽

Primary Hyperhidrosis ◽

Assess Quality

Objective: To assess quality of life before and after thoracoscopic sympathectomy for treatment of primary hyperhidrosis.Methods: we conducted an observational, analytical, cross-sectional and quantitative study. We evaluated patients undergoing thoracoscopic sympathectomy for primary axillary hyperhidrosis, primary palmar hyperhidrosis, and axillary hyperhidrosis associated with palmar one. We applied a questionnaire on quality of life related to hyperhidrosis before and after the operation.Results: The questionnaire was administered to 51 patients with a mean age of 32.4 years, 45 women and six men. The average quality of life related to hyperhidrosis in a score of 0-100 before sympathectomy was 34.6 and after the operation it was 77.1. Compensatory hyperhidrosis occurred in 84.3% of patients.Conclusion: thoracoscopic sympathectomy improves the quality of life of patients with primary hyperhidrosis, with results supported over time. Compensatory hyperhidrosis occurred in most patients, but did not significantly influence the improved quality of life.

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