Patient experience and prognostic factors of compensatory hyperhidrosis and recurrence after endoscopic thoracic sympathicotomy

Abstract

Objective We aimed to investigate compensatory hyperhidrosis (CH) and recurrence based on an online survey of patients who underwent endoscopic thoracic sympathicotomy(ETS) for palmar and/or axillary hyperhidrosis. Methods We enrolled 231 patients who underwent ETS for palmar and/or axillary hyperhidrosis from January 2008 to April 2021. Patients responded to an online questionnaire regarding CH and recurrence, their electronic medical records were reviewed. Logistic regression was performed to find the risk factors related to CH and recurrence. Results The median time of survey from surgery was 20 months. Although 94% of patients were satisfied with the surgery, 86.1% experienced CH; of them, it was severe in 30.7%. Three months after surgery, there was no long-term change in the severity of CH. The development of CH showed a close relationship with age of 20 years or more (OR: 2.73). Recurrence occurred in 44(19.0%) patients, and the use of anti-adhesive agents was a significant preventive factor against recurrence after ETS (OR: 0.42). Conclusions We observed that CH and recurrence after ETS for palmar and/or axillary hyperhidrosis were relatively common. Age at the time of surgery was associated with CH, and the use of anti-adhesive agents showed to lower the risk of recurrence after ETS.

Compensatory Hyperhidrosis After Non-Surgical Treatment of Primary Focal Hyperhidrosis: Two-Year Single-Centered Prospective Study From Jordan

“…14 In contrast, a study by Woo et al, found a significant correlation between age over 20 years and the development of CH (OR: 2.73). 15 CH after botulinum toxin treatment was reported in a very small number of studies. A clinical trial that aimed to investigate the safety and efficacy of BTX-A in axillary hyperhidrosis mentioned that only 11 patients (5%) developed CH.…”

“…14 In contrast, a study by Woo et al, found a significant correlation between age over 20 years and the development of CH (OR: 2.73). 15…”

Attempted treatment of primary axillary hyperhidrosis with one session of either Neodymium YAG laser or Intense Pulsed Light: A within patient randomized trial of treated versus untreated contralateral axilla

“…Thoracic sympathectomy and suction curettage may cause significant sweat reduction after 3−12 months 3–5 although suction curettage has proven inferior to botulinum toxin treatment 5 . However, compensatory hyperhidrosis in other body areas remains problematic 3,6 and the number of surgical corrections of PAH has declined over the last decade 7 . Iontophoresis and microneedle radiofrequency are not widely used for PAH due to fluctuating efficacy and the need for special equipment 8–10 .…”