Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China

Chen, Jianfeng; Liu, Yanguo; Yang, Jie; Hu, Jian; Peng, Jun; Gu, Lin; Deng, Bo; Li, Yuhua; Bing-yu, Gao; Sheng, Qibing; Chen, Guangchun; Zhang, Yi; Xie, Deyao; Wang, Jiyong; Zhan, Hua-hui; Tu, Yuan-rong

doi:10.1016/j.surg.2019.05.039

Cited by 26 publications

(26 citation statements)

References 21 publications

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“…Possibly some of these days in the ICU correspond to patients with severe early post-operative complications, such as pneumothorax or hemothorax, which have been reported by other authors (29). Nevertheless, no in-hospital death after ETS to treat HH was reported in the public hospitals of São Paulo between 2008 and 2018, as reported in other large studies (29,31), which emphasizes the low mortality associated with this treatment.…”

Section: Hospital and Icu Length Of Stay And In-hospital Mortalitysupporting

confidence: 65%

Population-based Cross-sectional Analysis of the Epidemiology of the Surgical Correction of Hyperhidrosis in 1216 Patients over 11 years

Silva

Louzada

Teivelis

et al. 2021

Preprint

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Background: Endoscopic thoracic sympathectomy is the definitive surgical treatment for hyperhidrosis, and a nationwide study suggested that it has been performed in a higher rate than which could have been expected due to climate characteristics, comparing to the national statistics. Objectives: To study the epidemiology of sympathectomy to treat hyperhidrosis in Sao Paulo, the largest city in the Southeast. Design and setting: population-based cross-sectional study. Methods: data on sympathectomies to treat hyperhidrosis between 2008 and 2018 were assessed from the database of the Municipal Health Secretary of Sao Paulo, Brazil. Results: 65.29% of the patients were female, 66.2% aged between 20 and 39 years and 37.59% had addresses registered outside Sao Paulo. 1216 procedures were performed in the city of Sao Paulo from 2008 to 2018, 78.45% of which in only two public hospitals. The number of procedures significantly declined over the years (p = 0.001). 71.63% of the procedures were associated with 2 to 3 days of hospital stay, only 78 intensive care unit days were billed and we did not observe any intra-hospital death. Conclusions: sympathectomies for the treatment of HH were widely performed in the city of Sao Paulo (1216 procedures), mainly in young (20 to 39 years) and female patients, with more than one third of the patients having addresses registered outside the city. This is a very safe surgery, with low need for intensive care units and no mortality in our series. There was a decreasing trend in the number of surgeries over the years.

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Section: Hospital and Icu Length Of Stay And In-hospital Mortalitysupporting

confidence: 65%

Population-based Cross-sectional Analysis of the Epidemiology of the Surgical Correction of Hyperhidrosis in 1216 Patients over 11 years

Silva

Louzada

Teivelis

et al. 2021

Preprint

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“…Finally, CH may be an important factor affecting the QOL of PH patients after ETS, as QOL after surgery was negatively correlated to the severity of CH. ETS is a safe and effective treatment for PH (4,11). It is able to locate the sympathetic chain accurately, provide cosmetic result, shorter length of hospital stay, and less bodily pain.…”

Section: Discussionmentioning

confidence: 99%

“…Patients' knowledge about the severity of CH and the permanent characteristic of surgery should be ensured. Postoperatively, proper psychological counselling is necessary for those with severe CH, since extremely disruptive psychologic state had been reported in some patients (11).…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up in quality of life before and after endoscopic thoracic sympathicotomy in 367 patients with palmar hyperhidrosis

Zhang¹,

Zhuang²,

Lan³

et al. 2022

Ann Palliat Med

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Background: Palmar hyperhidrosis (PH) hinders daily activities and deteriorates quality of life (QOL).Endoscopic thoracic sympathicotomy (ETS) is safe and efficient as the gold standard treatment for PH.So far, the long-term change of QOL after surgery has not been fully characterized, which is important to evaluate clinical benefits and helped to identify the true beneficiaries. In the current study, we aimed to investigate the long-term outcome of ETS by comparing their preoperative QOL with a follow-up QOL. Methods: This study enrolled 367 patients with PH who underwent ETS between March 2018 and March 2019. All patients were surveyed by a web-based questionnaire adapted from de Campos Quality-of-life Questionnaire for Evaluation of Hyperhidrosis, and compared to their preoperative results. Results: After a median follow-up of 14 months [interquartile range (IQR), 9-21 months], improvement in QOL was reported in 90.7% of patients. Compared to preoperative QOL [median (Md) =40, IQR, 37-45],postoperative QOL was significantly improved (Md =20, IQR, 13-23; P<0.001). A higher QOL score was noticed in patients with severer PH at diagnosis, whereas no significant difference was observed among postoperative QOL regarding the severity of PH. Subclinical compensatory hyperhidrosis (CH) occurred in 94.6% of post-ETS cases after long-term follow-up. The score of postoperative QOL was significantly positively correlated to the severity of CH (rs=0.14; P=0.009).Conclusions: Improvement in QOL sustained for a long-term period after receiving ETS for PH. Almost all patients developed subclinical CH on other body sites in the long run, with an impairment in QOL correlating with the severity of CH. Further investigations on the developing patterns of CH and clinical coping strategy are warranted to improve the long-term outcome of ETS.

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“…Success rates of over 90% for curing or improving symptoms of severe palmar hyperhidrosis have been described [24][25][26][27][28]. More recent studies by Chen et al and Feng et al, in which respectively 10.275 and 200 patients with palmar hyperhidrosis were treated with thoracoscopic sympathicotomy, even reported a success rate of 100% [29,30]. Nevertheless, literature comparisons should be interpreted with caution, since in most studies different nomenclature and definitions are used.…”

Section: The Current Status Of Minimally Invasive Sympathicotomy For Palmar Hyperhidrosismentioning

confidence: 99%

Minimally Invasive Sympathicotomy for Palmar Hyperhidrosis and Facial Blushing: Current Status and the Hyperhidrosis Expert Center Approach

Kuijpers

Zanden

Harms

et al. 2022

JCM

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Hyperhidrosis, the medical term for excessive sweating beyond physiological need, is a condition with serious emotional and social consequences for affected patients. Symptoms usually appear in focal areas such as the feet, hands, axillae and face. Non-surgical treatment options such as topical antiperspirants or systemic medications are usually offered as a first step of treatment, although these therapies are often ineffective, especially in severe and intolerable cases of hyperhidrosis. In the treatment algorithm for patients suffering from hyperhidrosis, surgical thoracoscopic sympathicotomy offers a permanent solution, which is particularly effective in the treatment of palmar hyperhidrosis and facial blushing. In this review, we describe the current status of thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing. In addition, we share the specific treatment approach, technique and results of our Hyperhidrosis Expert Center. Last, we share recommendations to ensure an effective, reproducible and safe application of single-port thoracoscopic sympathicotomy for palmar hyperhidrosis and facial blushing, based on our extensive experience.

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Endoscopic thoracic sympathicotomy for primary palmar hyperhidrosis: A retrospective multicenter study in China

Cited by 26 publications

References 21 publications

Population-based Cross-sectional Analysis of the Epidemiology of the Surgical Correction of Hyperhidrosis in 1216 Patients over 11 years

Population-based Cross-sectional Analysis of the Epidemiology of the Surgical Correction of Hyperhidrosis in 1216 Patients over 11 years

Long-term follow-up in quality of life before and after endoscopic thoracic sympathicotomy in 367 patients with palmar hyperhidrosis

Minimally Invasive Sympathicotomy for Palmar Hyperhidrosis and Facial Blushing: Current Status and the Hyperhidrosis Expert Center Approach

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