Prospective randomized study comparing Video assisted thoracoscopic surgery (VATS) resection versus cautery for treatment of primary hyperhydrosis

Karmota, Ahmed G; Aboollo, Moustafa F.; Hafez, Bassem A.; Shaker, Ahmed; Ghoneim, Baker

doi:10.1016/j.jescts.2018.11.005

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…Better visualization of the stellate ganglion and its preservation to avoid development of post-operative Horner's syndrome. [11] As noted in many studies, the plantar domain affects considerable part of those patients of about 45% [4]; while others reported incidence of plantar domain of 70 to 100 % of patients with primary hyperhidrosis; latter researchers used extended technique of ablation from R3 to R12 to manage those cases [12]. In the Society of Thoracic Surgeons 2011 Expert Consensus for the Surgical Treatment of Hyperhidrosis [13], no recommendations for plantar domain management were noted.…”

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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Section: Discussionmentioning

confidence: 99%

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

Aly

Soliman

Zaid

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Concerning the importance of the palmo-plantar type, the plantar domain affects considerable part (about 45%) of those patients with PH [4]. Other studies reported incidence of plantar domain of 70 to 100% in patients with PH; the latter researchers used extended technique of ablation from R3 to R12 to manage those cases [25].…”

Section: Discussionmentioning

confidence: 99%

“…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%, both in 55%, and plantar hyperhidrosis in 45% of cases [2,4].…”

Section: Introductionmentioning

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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Clinical Outcomes of Uniportal Versus Multiportal Endoscopic Thoracic Sympathectomy in Patients With Severe Palmar and Axillary Hyperhidrosis

ASLANER¹

2022

Acta Medica Alanya

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Objective: Palmar and axillary hyperhidrosis is caused by overstimulation of the sympathetic nervous system that control the sweat glands. This study compares the clinical consequences of uniportal and multiportal thoracic endoscopic thoracic sympathectomy (ETS), in cases of severe palmar and axillary hyperhidrosis. Methods: In this retrospective study, forty-one patients who were diagnosed as severe palmar and axillary primary hyperhidrosis were analyzed. These underwent multiportal ETS between 2015 and 2020 at our thoracic surgery clinic. They were divided into two groups, 24 as uniportal (58.5%) and 17 as multiportal (41.5%). They were compared in terms of the length of hospital stay, the initial complications and possible recurrences after three months. Descriptive statistics were used to evaluate stratified and continuous variables. Results: There was no significant difference in moderate pain between the two groups. There was a significant difference between the two groups in terms of 3 days or more hospitalization. There were no significant difference related to the rate of complications such as ptosis, Horner syndrome, increased duration of surgery and recurrence rate of hyperhidrosis 3 months after surgery. Some mild to moderate side effects disappeared spontaneously at 6-month follow-up. Conclusion: The results showed that uniportal and multiportal endoscopic thoracoscopic sympathectomy (EST) are very effective, safe and minimally invasive methods for the treatment of palmar and axillary hyperhidrosis. Compared to the multiportal approach, uniportal EST causes less postoperative pain and less surgical duration.

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Prospective randomized study comparing Video assisted thoracoscopic surgery (VATS) resection versus cautery for treatment of primary hyperhydrosis

Cited by 3 publications

References 22 publications

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

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

Clinical Outcomes of Uniportal Versus Multiportal Endoscopic Thoracic Sympathectomy in Patients With Severe Palmar and Axillary Hyperhidrosis

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