Management of Compensatory Sweating After Sympathetic Surgery

Wolosker, Nelson; Campos, José Ribas Milanez de; Fukuda, Juliana Maria

doi:10.1016/j.thorsurg.2016.06.009

Cited by 31 publications

(35 citation statements)

References 52 publications

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“…The CS rates reported in literature range from 60% up to 90%. [13][14][15][16][17][18][19] This vast difference can be attributed to more than one reason. It is known that the level of sympathetic denervation, the surgical technique, and even the patient's body mass index can affect the development of CS.…”

Section: Discussionmentioning

confidence: 99%

“…It is known that the level of sympathetic denervation, the surgical technique, and even the patient's body mass index can affect the development of CS. [13][14][15][16][17][18][19] In addition to these variables, another reason may be the fact that the definition of CS varies from researcher to researcher. It has not yet been established what amount of postoperative sweating can be considered CS, and what is attributable to postoperative thermoregulation.…”

Section: Discussionmentioning

confidence: 99%

“…13,[17][18][19] Although some studies have attempted to group CS as mild or severe, there is no clear boundary between the expected physiological increase and pathological increase in the postoperative period. 13,[17][18][19] In the present study, great care and attention were paid to this issue. The patients were first asked whether they had experienced any increase in sweating in any part of their body after the operation, and 97 (70.8%) replied in the positive.…”

Section: Discussionmentioning

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: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…Hastaların yaş ortalaması 22.7 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) (3,6). Hiperhidrozisi tedavi etmek için ilk yapılan sempatektomi 1920 yılında Kotzaref tarafından bildirildi (8).…”

Section: Bulgularunclassified

“…Kompansatris terleme ETS'nin en yaygın komplikasyonudur ve literatürde tüm farklı cerrahi yaklaşımlar arasında görülme sıklığı %3 ile %98 arasında değişmektedir (21,22). Kompansatris terleme ile ilişkili en iyi bilinen faktörler, sempatik zincirin manüplasyonunun genişletilmesi, sempatik denervasyon seviyesi ve vücut kitle endeksidir (23). Genellikle ameliyattan 6 ay sonra başlayıp 9'uncu ayda en yüksek seviyesine çıkmaktadır.…”

Section: Bulgularunclassified

Single-port bilateral endoscopic thoracic sympathectomy for the treatment of hyperhidrosis

Ocakcıoğlu¹

2019

Van Med J

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Reversal of thoracic sympathectomy through robot‐assisted microsurgical sympathetic trunk reconstruction with sural nerve graft and additional end‐to‐side coaptation of the intercostal nerves: A case report

et al. 2021

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Thoracic sympathectomy to treat palmar hyperhidrosis (PH) has widely been performed.Many patients regret the surgery due to compensatory hyperhidrosis (CH), gustatory hyperhidrosis, arrhythmia, hypertension, gastrointestinal disturbances, and emotional distress. Robotic applications in microsurgery are very limited. We report the technique and long-term patient-reported outcomes of bilateral robot-assisted microsurgical sympathetic trunk reconstruction with a sural nerve graft in an interdisciplinary setting. A 59-year-old female suffered from severe adverse effects after endoscopic thoracic sympathectomy (ETS) for PH 25 years ago. She reported CH over the whole trunk, gustatory hyperhidrosis, excessive dry hands, and emotional distress. An interdisciplinary surgical team performed a bilateral sympathetic trunk reversal reconstruction with an interpositional sural nerve graft per side by a da Vinci ® Robot. The nerve graft was microsurgically coapted using 9-0 sutures end-to-end to the sympathetic trunk stumps and side-to-end to the intercostal nerves T2-T4. At 24, 33 and 42 months, palmar dryness and emotional distress were strongly reduced. A highly specialized interdisciplinary setting may provide a precise, safe, and efficient treatment for ETS sequelae. A clinical study is initiated to validate this new therapy.

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Management of Compensatory Sweating After Sympathetic Surgery

Cited by 31 publications

References 52 publications

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

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

Single-port bilateral endoscopic thoracic sympathectomy for the treatment of hyperhidrosis

Reversal of thoracic sympathectomy through robot‐assisted microsurgical sympathetic trunk reconstruction with sural nerve graft and additional end‐to‐side coaptation of the intercostal nerves: A case report

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