Subscribe to RSS
DOI: 10.1055/s-0041-1728777
Long-Term Outcomes and Course of Compensatory Sweating after Endoscopic Sympathicotomy
![](https://www.thieme-connect.de/media/thoracic/202202/lookinside/thumbnails/10-1055-s-0041-1728777_216186ot-1.jpg)
Abstract
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.
Publication History
Received: 27 January 2021
Accepted: 15 March 2021
Article published online:
27 May 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Nahaloni E, Iancu I. [Hyperhidrosis and social anxiety disorder--the same old thing under a different cloak?]. Harefuah 2014; 153 (10) 595-599 , 624
- 2 Fujimoto T. Pathophysiology and treatment of hyperhidrosis. Curr Probl Dermatol 2016; 51: 86-93
- 3 Schick CH. Pathophysiology of hyperhidrosis. Thorac Surg Clin 2016; 26 (04) 389-393
- 4 McConaghy JR, Fosselman D. Hyperhidrosis: management options. Am Fam Physician 2018; 97 (11) 729-734
- 5 Nawrocki S, Cha J. The etiology, diagnosis, and management of hyperhidrosis: a comprehensive review: Etiology and clinical work-up. J Am Acad Dermatol 2019; 81 (03) 657-666
- 6 Schnider P, Moraru E, Kittler H. et al. Treatment of focal hyperhidrosis with botulinum toxin type A: long-term follow-up in 61 patients. Br J Dermatol 2001; 145 (02) 289-293
- 7 Horslen LC, Wilshire CL, Louie BE, Vallières E. Long-term impact of endoscopic thoracic sympathectomy for primary palmar hyperhidrosis. Ann Thorac Surg 2018; 106 (04) 1008-1012
- 8 Wolosker N, de Campos JR, Kauffman P, de Oliveira LA, Munia MA, Jatene FB. Evaluation of quality of life over time among 453 patients with hyperhidrosis submitted to endoscopic thoracic sympathectomy. J Vasc Surg 2012; 55 (01) 154-156
- 9 Sugimura H, Spratt EH, Compeau CG, Kattail D, Shargall Y. Thoracoscopic sympathetic clipping for hyperhidrosis: long-term results and reversibility. J Thorac Cardiovasc Surg 2009; 137 (06) 1370-1376 , discussion 1376–1377
- 10 Dumont P, Denoyer A, Robin P. Long-term results of thoracoscopic sympathectomy for hyperhidrosis. Ann Thorac Surg 2004; 78 (05) 1801-1807
- 11 Du X, Zhu X, Wang T. et al. Compensatory hyperhidrosis after different surgeries at the same sympathetic levels: a meta-analysis. Ann Transl Med 2018; 6 (11) 203
- 12 Moraites E, Vaughn OA, Hill S. Incidence and prevalence of hyperhidrosis. Dermatol Clin 2014; 32 (04) 457-465
- 13 Licht PB, Pilegaard HK. Severity of compensatory sweating after thoracoscopic sympathectomy. Ann Thorac Surg 2004; 78 (02) 427-431
- 14 Glaser DA, Hebert A, Pieretti L, Pariser D. Understanding patient experience with hyperhidrosis: a national survey of 1,985 patients. J Drugs Dermatol 2018; 17 (04) 392-396
- 15 Bachmann K, Standl N, Kaifi J. et al. Thoracoscopic sympathectomy for palmar and axillary hyperhidrosis: four-year outcome and quality of life after bilateral 5-mm dual port approach. Surg Endosc 2009; 23 (07) 1587-1593
- 16 Hu Y, Converse C, Lyons MC, Hsu WH. Neural control of sweat secretion: a review. Br J Dermatol 2018; 178 (06) 1246-1256
- 17 Yuncu G, Turk F, Ozturk G, Atinkaya C. Comparison of only T3 and T3-T4 sympathectomy for axillary hyperhidrosis regarding treatment effect and compensatory sweating. Interact Cardiovasc Thorac Surg 2013; 17 (02) 263-267
- 18 Cai SW, Shen N, Li DX, Wei B, An J, Zhang JH. Compensatory sweating after restricting or lowering the level of sympathectomy: a systematic review and meta-analysis. Clinics (São Paulo) 2015; 70 (03) 214-219
- 19 Wolosker N, Milanez de Campos JR, Fukuda JM. Management of compensatory sweating after sympathetic surgery. Thorac Surg Clin 2016; 26 (04) 445-451
- 20 Hynes CF, Yamaguchi S, Bond CD, Marshall MB. Reversal of sympathetic interruption by removal of clips. Ann Thorac Surg 2015; 99 (03) 1020-1023
- 21 Park HS, Hensman C, Leong J. Thoracic sympathetic nerve reconstruction for compensatory hyperhidrosis: the Melbourne technique. Ann Transl Med 2014; 2 (05) 45
- 22 Melek H, Çetinkaya G, Özer E, Yentürk E, Bayram AS, Gebitekin C. Intercostal nerve reconstruction in the treatment of severe compensatory hyperhidrosis “Gebitekın technique” 9th Thoracic Surgery Congress, Turkey May 2017
- 23 Turhan K, Cakan A, Cagirici U. Preserving T2 in thoracic sympathicotomy for palmar hyperhidrosis: less tissue trauma, same effectiveness. Thorac Cardiovasc Surg 2011; 59 (06) 353-356