Compensatory hyperhidrosis after different surgeries at the same sympathetic levels: a meta-analysis

Du, Xiao‐Jun; Zhu, Xu; Wang, Tao; Hu, Xiaolei; Lin, Peng; Teng, Yin; Fan, Chao Qiang; Li, Jianglun; Yang, Xi; Xiao, Jiangjian; Li, Wen; Zhang, Jian; Zhou, Haiyu; Tian, Dan; Yuan, Shizhang

doi:10.21037/atm.2018.05.24

Cited by 16 publications

(23 citation statements)

References 37 publications

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“…Many techniques have been described for the treatment of hyperhidrosis, such as sympathicotomy, sympathectomy, and the use of endoscopic clips, and there have been many studies evaluating the advantages of these techniques over each other with focus on different areas, such as complication rates, efficacy, and the chance of reoperation in cases of CS development. 9,11,17,18,23 The present study made no attempt to compare these techniques with each other, or to identify the safest treatment method. While criticizing this point, it should be noted that the primary purpose of the present study was to try to garner data on the long-term outcomes of the operation in as standardized a patient group as possible.…”

Section: Discussionmentioning

confidence: 97%

“…with the development of CS has been investigated in literature. [7][8][9][10][11] Again, there is limited information on the course of CS over time, and so the secondary objective of the our study is to obtain such data as the time to CS development after the operation, its change over time, and the extent to which it affects patient satisfaction.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Outcomes and Course of Compensatory Sweating after Endoscopic Sympathicotomy

Turhan

Kavurmacı

Akçam

et al. 2021

Thorac Cardiovasc Surg

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Background Endoscopic thoracic sympathicotomy is an effective approach to the treatment of idiopathic localized hyperhidrosis, and compensatory sweating is the main reason for patient dissatisfaction. Our study discusses both the long-term outcomes of sympathicotomy and the course of compensatory sweating. Methods Patients with palmar and/or axillary hyperhidrosis who were operated by the same surgical team between January 2008 and December 2014 were included in the study. After at least 5 years (60 months) from operation, patients were questioned about their treatment outcomes by using an original survey form. Results Of the 137 patients included in the study, 88 (64.2%) were female and 49 (35.8%) were male. The mean time from the operation to the survey interview was 80.9 ± 14.1 (64–136) months. After operation, complaints disappeared in 95.1% of the patients, and decreased in 4.9% with palmar hyperhidrosis. Complaints completely disappeared in 12.9% and decreased in 81.7% of the patients with axillary hyperhidrosis. Ninety-seven (70.8%) of the patients described increased sweating in some parts of their body after operation but only 47 reached an uncomfortable intensity. The number of patients who regretted the operation due to the compensatory sweating was 13 (9.5%). The patients' overall scoring of the operation and procedure was calculated as 8.0 ± 2.1 (0–10 points) out of 10. Conclusion Endoscopic thoracic sympathicotomy's long-term outcomes are also satisfactory in the treatment of palmar and axillary hyperhidrosis. Compensatory sweating may decrease over time, only a minority of patients will express regret at undergoing the treatment.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes and Course of Compensatory Sweating after Endoscopic Sympathicotomy

Turhan

Kavurmacı

Akçam

et al. 2021

Thorac Cardiovasc Surg

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“…Both sides can be treated in the same sitting, thus avoiding readmission for a second procedure for the opposite side. [10] The thoracoscopic approach allows clear delineation of the sympathetic chain and the ganglia including the collateral branches (Kuntz's nerves). Better visualization of the stellate ganglion and its preservation to avoid development of post-operative Horner's syndrome.…”

Section: Discussionmentioning

confidence: 99%

Palmo-Plantar Hyperhidrosis: Does Drainless One-port Thoracoscopic Sympathectomy (DOTS) help?

Aly

Soliman

Zaid

et al. 2020

Preprint

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Objectives: Primary hyperhidrosis (PH) still impacts negatively the patients' quality of life (QoL). Progressively, it leads to poorer QoL regardless of gender; finally, it ends up causing psycho-social and professional embracement to patients. The thoracoscopic sympathectomy (TS) has been used safely and effectively for control of palmar hyperhidrosis; but it is still questionable in palmo-plantar type. We assessed the benefits of drainless one-port thoracoscopic sympathectomy (DOTS) in palmo-plantar and palmar hyperhidrosis. Methods: This prospective study comprised 213 consecutive patients with PH who underwent bilateral simultaneous DOTS. We used the Hyperhidrosis Disease Severity Scale (HDSS) scoring system for assessment of quality of life pre-and post-operatively. Follow up continued for one-year interval for quality of life, recurrence, and compensatory hyperhidrosis. Results: All patients experienced immediate complete resolution of hyperhidrosis postoperatively. Recurrence encountered in one patient during first 6 months. All patients had improved quality of life postoperatively; but at the end of 1-year follow up, 2.8 % of patients were still suffering moderate to severe impaired QoL. Mean hospital stay was 31.79±17.5 hours. We found significant longer hospital stay in palmar group than palmo-plantar group. There was no significant difference between both groups in neither operative time, recurrence, nor compensatory hyperhidrosis. Conclusions: DOTS offers better quality of life for patients with primary hyperhidrosis even the palmo-plantar type. The palmo-plantar type benefits similarly to the palmar type. In palmo-plantar hyperhidrosis, we should rethink again about post-operative plantar hyperhidrosis; it is accepted redistribution compensatory hyperhidrosis rather than a miserable recurrence. Introduction: Hyperhidrosis is a sweat glands' benign functional disorder. Usually, it presents by heat or emotional stimulated excessive sweating beyond the physiological needs. Moreover, it causes psycho-social and professional embracement that negatively impacts the quality of life (QoL). [1-3] Hyperhidrosis may be primary or secondary. The etiology of primary hyperhidrosis (PH) is still unknown. It affects about 0.6 to 1% in the general population. The most usual sites or domains of hyperhidrosis are the hands in 25% of cases, armpit in 20% and both in 55%, while plantar hyperhidrosis noted in 45% of cases. [2, 4] Management of those patients includes many medications as topical medication and botulinum toxin injection. [5] In 1920s, the trans-thoracotomy surgical treatment started to appear in medical practice with significant patient morbidity so, it failed to generate widespread acceptance. [6] Evolving thoracoscopy approach enhanced the thoracoscopic sympathectomy to become the surgical technique of choice for treating PH. This minimally invasive procedure is simple and safe, with a high success rate with low morbidity and short hospital stay.[7] Although being an effective method for management of PH,...

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“…This minimally invasive approach has many benefits as reducing postoperative pain, shorter hospitalization, earlier recovery and return to work, and fewer complications. Both sides can be treated in the same sitting, thus avoiding readmission for a second procedure for the opposite side [11].…”

Section: Discussionmentioning

confidence: 99%

Uniportal video-assisted thoracoscopic drainless sympathectomy for palmar and palmo-plantar hyperhidrosis: an institutional experience

et al. 2020

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Background Primary hyperhidrosis (PH) still impacts negatively the patient’s quality of life (QoL). Progressively, it leads to poorer QoL regardless of gender. The endoscopic thoracic sympathectomy has been used safely and effectively for control of palmar hyperhidrosis, but it is still questionable in palmo-plantar type. We assessed the benefits of uniportal drainless thoracoscopic sympathectomy (UDTS) for palmo-plantar hyperhidrosis patients compared to palmar ones. This prospective study comprised 213 consecutive patients with PH. They underwent bilateral simultaneous UDTS. We used the Hyperhidrosis Disease Severity Scale (HDSS) scoring system for assessment of QoL pre- and postoperatively. Follow-up was continued for 1-year that was aiming to detect the QoL improvement, recurrence, and compensatory hyperhidrosis (CH). Results All patients experienced immediate complete resolution of hyperhidrosis postoperatively. Recurrence was encountered in one patient during the first 6 months. All patients had improved QoL postoperatively, but at the end of 1-year follow-up, 2.8% of patients were still suffering moderate to severe impaired QoL. Mean hospital stay was 31.79 ± 17.5 h. We found significant longer hospital stay in palmar group than palmo-plantar group. There was no significant difference between both groups in neither operative time, recurrence, nor CH. Conclusions UDTS offers better QoL for patients with PH even the palmo-plantar type. The palmo-plantar type benefits similarly to the palmar type in terms of comparable postoperative QoL and CH incidence.

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Compensatory hyperhidrosis after different surgeries at the same sympathetic levels: a meta-analysis

Abstract: If only CH and the same sympathetic levels concerned, sympathectomy and sympathicotomy is equal for upper limb hyperhidrosis and FH. And, ESC should be recommended for a lower incidence of CH, comparing with sympathicotomy.

Cited by 16 publications

References 37 publications

Long-Term Outcomes and Course of Compensatory Sweating after Endoscopic Sympathicotomy

Long-Term Outcomes and Course of Compensatory Sweating after Endoscopic Sympathicotomy

Palmo-Plantar Hyperhidrosis: Does Drainless One-port Thoracoscopic Sympathectomy (DOTS) help?

Uniportal video-assisted thoracoscopic drainless sympathectomy for palmar and palmo-plantar hyperhidrosis: an institutional experience

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