Comparative analysis of the results of videothoracoscopic sympathectomy in the treatment of hyperhidrosis in adolescent patients

Wolosker, Nelson; Faustino, Carolina Brito; Campos, José Ribas Milanez de; Kauffman, Paulo; Yazbek, Guilherme; Fernandes, Paulo Pêgo; Cucato, Gabriel Grizzo

doi:10.1016/j.jpedsurg.2019.11.004

Cited by 13 publications

(11 citation statements)

References 39 publications

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“…Mean BMI in our study was 23.1±2.9 going similarly with Wolosker n. et al [14] study who reported mean BMI of 20.6±3 and 21.9±2.55 for their adolescent and adult groups. Repeatedly, different studies reported that results will not be satisfactory in patients with higher BMI, because of an increased prevalence of severe CH has been demonstrated in patients with a BMI higher than 25 [15].…”

Section: Discussionsupporting

confidence: 91%

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: Discussionsupporting

confidence: 91%

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

Aly

Soliman

Zaid

et al. 2020

Preprint

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“…Mean BMI in our study was 23.1 ± 2.9. This is going similarly with Woloske et al's [19] study who reported mean BMI of 20.6 ± 3 and 21.9 ± 2.55 for their adolescent and adult groups. Miller et al [20], in their study of 282 patients, found that increased BMI was associated with increased CH.…”

Section: Discussionsupporting

confidence: 89%

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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“…Sweating is a physiological mechanism of human thermoregulation. Sweat gland hyperfunction or HH is a very common disease that affects young people during their maturation phase (23). Our patients were in the third decade of life, and more than 80% of patients experienced palmar or axillary HH.…”

Section: ' Discussionmentioning

confidence: 91%

Symptoms of anxiety and depression in patients with primary hyperhidrosis and its association with the result of clinical treatment with oxybutynin

Kamikava

Wolosker

Silva

et al. 2021

Clinics

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Studies have identified correlations between the psychological characteristics of individuals with primary hyperhidrosis (HH), the degree of sweating, and the quality of life (QoL). This study aimed to evaluate the prevalence of anxiety and depression symptoms in patients with HH before and after oxybutynin treatment. METHODS: Data were collected from 81 patients. Palmar or axillary HH was the most frequent complaint (84.0%). All patients were evaluated before the medication was prescribed and after five weeks of treatment. The Beck Depression Inventory and Beck Anxiety Inventory were used to evaluate depression and anxiety. RESULTS: Improvement in HH occurred in 58 patients (71.6%), but there was no improvement in 23 patients (28.4%). The QoL before treatment in all patients was either ''poor'' or ''very poor.'' Patients who experienced improvement in sweating rates also experienced a greater improvement in QoL than patients who did not experience improvement in sweating at the main site (87.9% vs. 34.7%) (po0.001). A total of 19.7% of patients showed an improvement in their level of depression, and a total of 46.9% of patients exhibited improvements in their level of anxiety. A significant correlation was observed between sweating and anxiety (p=0.015). CONCLUSION: Patients with HH who experienced improvements in sweating immediately after treatment with oxybutynin exhibited small improvements in their levels of depression and significant improvements in their levels of anxiety and QoL.

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Comparative analysis of the results of videothoracoscopic sympathectomy in the treatment of hyperhidrosis in adolescent patients

Cited by 13 publications

References 39 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

Symptoms of anxiety and depression in patients with primary hyperhidrosis and its association with the result of clinical treatment with oxybutynin

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