An assessment of plantar hyperhidrosis after endoscopic thoracic sympathicolysis

Ureña, Anna; Ramos, Ricard; Masuet, Cristina; Macía, Iván; Rivas, Francisco; Escobar, Ignacio; Villalonga, R.; Moya, Juan

doi:10.1016/j.ejcts.2009.02.062

Cited by 8 publications

(7 citation statements)

References 16 publications

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“…Although palmar hyperhidrosis is a the most common form of PH, plantar hyperhidrosis frequently accompanies palmar hyperhidrosis (1,8,9). There is no consensus regarding the management of plantar hyperhidrosis combined with palmar hyperhidrosis (8,(11)(12)(13)18,19).…”

Section: Discussionmentioning

confidence: 99%

“…Usually, the upper thoracic sympathetic levels ranging from T2 to T5 by various methods are blocked according to the hyperhidrosis type, patient condition, and surgeon preference (5)(6)(7). Although palmar hyperhidrosis is a predominant form of PH, plantar hyperhidrosis also occurs in >50% of cases (1,8,9). When upper thoracic sympathetic blockage is performed for palmar hyperhidrosis accompanied by plantar hyperhidrosis, there is sometimes an improvement in plantar hyperhidrosis (10)(11)(12).…”

Section: Original Articlementioning

confidence: 99%

“…When upper thoracic sympathetic blockage is performed for palmar hyperhidrosis accompanied by plantar hyperhidrosis, there is sometimes an improvement in plantar hyperhidrosis (10)(11)(12). Many studies have investigated the effect of upper thoracic sympathectomy on plantar hyperhidrosis (4,7,9,13,14). However, the results vary across studies for unclear reasons (4,(12)(13)(14)(15).…”

Section: Original Articlementioning

confidence: 99%

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Effects of lower thoracic sympathicotomy on plantar hyperhidrosis

Jeong

Kim

et al. 2021

J Thorac Dis

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Background: The purpose of this study was to investigate whether performing lower thoracic sympathicotomy (LTS) from T10 to T12 affects plantar hyperhidrosis in patients with palmo-plantar (PP) or palmo-axillary-plantar (PAP) hyperhidrosis. Methods: Between January 2015 and January 2020, all consecutive patients with primary hyperhidrosis who underwent bilateral thoracoscopic sympathicotomy and met the inclusion criteria were included.Sympathicotomy was performed using one of the following two methods: the conventional upper thoracic vs. expanded thoracic sympathicotomy. In the expanded thoracic sympathicotomy, we expanded the level of sympathicotomy ranging from R5 to R12 in addition to the conventional upper thoracic sympathicotomy (R3 or R4). In cases of the expanded thoracic sympathicotomy, we defined the LTS as a sympathicotomy of the levels ranging from R10 to R12, which are related to plantar hyperhidrosis. Results: A total of 103 subjects with PP (71 cases) or PAP (32 cases) hyperhidrosis were included. Palmar or axillary hyperhidrosis in all patients were alleviated after sympathicotomy. There was no difference in sweating decrease or CH according to the hyperhidrosis types or sympathicotomy techniques. In addition, no-LTS was performed in 77 cases and LTS was performed in 26 cases. In the no-LTS group, there were 65 and 12 cases of low and high degrees of CH, respectively. In the LTS group, there were 22 and four cases of low and high degrees of CH, respectively. There was no significant difference in CH between the no-LTS and LTS groups (P=0.981). Improvement in plantar hyperhidrosis in the no-LTS group was observed in 29 of 77 cases, while improvement in plantar hyperhidrosis in the LTS group was observed in 16 of 26 cases. The addition of LTS lead to significant improvement in plantar hyperhidrosis (P=0.034).Conclusions: Performing LTS is a safe and feasible procedure that improved plantar sweating more so than it did in cases that did not undergo LTS. Therefore, we cautiously suggest that adding LTS helps in the treatment of plantar hyperhidrosis combined with palmar hyperhidrosis. Further studies on LTS are needed to validate these findings and will be helpful in establishing management guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

Section: Original Articlementioning

confidence: 99%

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Effects of lower thoracic sympathicotomy on plantar hyperhidrosis

Jeong

Kim

et al. 2021

J Thorac Dis

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“…We observed many patients with palmo-axillo-plantar HH reporting sustained and satisfactory improvement in plantar HH after TS. A literature review [3,4,7,8,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] revealed that the degree of improvement in plantar HH after TS varied according to the primary indication for and the level and method of TS (Supplemental Table 1).…”

Section: Commentmentioning

confidence: 99%

“…Palmo-axillo-plantar HH is considered a unique variant of primary HH that was presumed to be a hereditary autosomal-dominant disease with a familial incidence ranging from 12.5% to 56.5% [5,6]. Some studies estimated that palmo-plantar and palmo-axillo-plantar variants present in approximately 70% to 100% of patients with HH [7,8]. Excess plantar sweating represents an embarrassing problem to the patient and is usually treated with lumbar sympathectomy that is associated with technical difficulties, complications, such as retrograde ejaculation, and sometimes failure due to inadequate removal of the sympathetic chain [9].…”

mentioning

confidence: 99%

Sequential Extended Thoracoscopic Sympathicotomy for Palmo-Axillo-Plantar Hyperhidrosis

Elalfy

Emile

Elfeki

et al. 2017

The Annals of Thoracic Surgery

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Sequential extended thoracoscopic sympathicotomy proved to be an effective method for the treatment of combined HH because it achieved satisfactory and sustained improvement of palmar, axillary, and plantar sweating. Although the benefits of sequential extended thoracoscopic sympathicotomy outweigh its drawbacks and technical difficulties, further prospective studies are required to ascertain the effectiveness of this new technique.

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