Hiperhidrosis primaria. Situación actual de la cirugía del simpático

Surgical treatment of axillary hyperhidrosis by suction-curettage of sweat glands

“…According to the authors, these techniques have long duration, demand excessive dedication and perseverance from patients, and have only provide uncertain results so far. 19 However, it is important to note that, although the emotional stimulus is necessary for primary hyperhidrosis to occur in affected patients, it is not a psychological disease but rather a physiological disorder. 20 …”

“…Total or partial removal, or disconnection of the T3-T4 thoracic ganglia is performed for the treatment of axillary hyperhidrosis. 18 , 19 Unfortunately, it involves a large number of possible complications, such as arterial bleeding, bleeding from intercostal veins, hemopericardium, pleural effusion or adhesion , peripheral nerve injuries , gustatory sweating, complete or incomplete Claude-Bernard-Horner syndrome, neuralgia, hemothorax, pneumothorax, subcutaneous emphysema, chylothorax, and compensatory sweating. 1 , 18 , 29 , 30 Although the majority of these complications is rare, compensatory sweating is a relatively common side effect of sympathectomy, with occurrence rates ranging from 60 to 90% in some series.…”

“… 31 The most commonly affected sites are the back, abdomen, thighs and chest. 19 , 32 It is often considered by patients to be worse than the initial clinical picture that led them to seek surgical treatment. It is considered the main cause of dissatisfaction in many studies.…”