Number of Preoperative Hyperhidrosis Sites Does Not Affect the Sympathectomy Postoperative Results and Compensatory Hyperhidrosis Occurrence

Wolosker, Nelson; Leiderman, Dafne Braga Diamante; Campos, José Ribas Milanez de; Kauffman, Paulo; Tedde, Miguel Lia; Yazbek, Guilherme; Puech-Leão, Pedro

doi:10.1055/s-0038-1667317

Cited by 10 publications

(16 citation statements)

References 29 publications

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“…Recurrence hyperhidrosis requiring re-operation and chronic pain was not observed in any patient during the follow-up process (HDSS > 3). The mean PHSS of all patients was 8.1 (range, [3][4][5][6][7][8][9][10][11][12][13][14], and there was a statistically significant difference between the groups in terms of PHSS (►Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…It is reported that the reason for observing no changes in the QOL after sympathectomy is related to surgical failure, and this failure rate is around 5%. 12 Surgical failure can be defined as observing no decrease in the main complaint site in the short/medium term. This possibility is an important issue, like the presence of RS, that should be discussed with the patient in the preoperative period.…”

Section: Discussionmentioning

confidence: 99%

“…The scores higher than 84 were considered as much worse postoperative QOL, between 68 and 83 worse, 52 and 67 equal (no change after the surgery), 36 and 51 little better, and 20 and 35 much better. 12 Postoperative clinical change of sweating in the main complaint site was evaluated with Sweating Evolution Questionnaire (SEQ). 16 SEQ was based on a scale ranging between 0 and 10.…”

Section: Measurementsmentioning

confidence: 99%

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Does the Sweating Severity of Primary Hyperhidrosis Sites Affect Post-Sympathotomy Results?

Çınar

Çelik

2020

Thorac Cardiovasc Surg

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Background Improvement in quality of life (QOL) and patient satisfaction after endoscopic thoracic sympathotomy (ETS) in patients with primary hyperhidrosis may be affected by various factors. We examined whether the preoperative sweating severity of primary hyperhidrosis sites affects postoperative results. Methods The records of 112 patients who underwent bilateral ETS were reviewed retrospectively. The patients were divided into three groups according to the sweating severity score obtained from all primary hyperhidrosis sites (primary hyperhidrosis severity score [PHSS]) and analyzed comparatively. Group A (PHSS = 1–4) included 22 patients, Group B (PHSS = 5–8) 36 patients, and Group C (PHSS ≥ 9) 54 patients. Outcome measures included QOL prior to surgery, improvement in QOL after surgery, degree of clinical improvement, presence, severity, localization, and site number of reflex sweating (RS) and general patient satisfaction after 6 months of surgery. Results The preoperative QOL of patients with higher PHSS (groups B, C) was worse than other patients (group A). More than 91% of all patients had any level improvement in QOL, and over 96% had slight or great clinical improvement. RS developed in 80% of the patients, mostly in the back, very severe in 8%, and in median two different body areas. The overall patient satisfaction rate was more than 95%. There was no significant difference between the three groups in terms of all postoperative results. Conclusion Preoperative sweating severity of primary hyperhidrosis sites does not affect post-sympathotomy results. Surgeons should not be worried when deciding upon surgery, even in patients with high sweating severity.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Measurementsmentioning

confidence: 99%

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Does the Sweating Severity of Primary Hyperhidrosis Sites Affect Post-Sympathotomy Results?

Çınar

Çelik

2020

Thorac Cardiovasc Surg

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“…The procedure commonly used for the treatment of palmar hyperhidrosis is one-stage (under the same anesthetic act) bilateral thoracic sympathectomy by videothoracosocopy [ [4] , [5] , [6] ].…”

Section: Introductionmentioning

confidence: 99%

“…The wide variability of CS incidence can be affected by several factors like heterogeneous patient populations, a variety of sympathetic denervation techniques, or more important to a lack of objective methodology for defining CS [ 6 , 11 , 12 ]. In order to reduce the incidence of CS, some authors have studied the two-stage operative treatment, which consists of the initial approach of the dominant limb followed by contralateral limb surgery at a later time.…”

Section: Introductionmentioning

confidence: 99%

A prospective controlled randomized multicenter study to evaluate the severity of compensatory sweating after one-stage bilateral thoracic sympathectomy versus unilateral thoracic sympathectomy in the dominant side

Hamilton

Tedde

Wolosker

et al. 2020

Contemporary Clinical Trials Communications

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Objective To evaluate the contribution that unilateral thoracic sympathectomy in dominant side or two-stage bilateral thoracic sympathectomy can have as strategies to reduce the incidence of compensatory sweating after sympathectomy for palmar hyperhidrosis. Methods This is a prospective, controlled, randomized multicenter trial of 200 participants with palmar hyperhidrosis, which will be randomized into two arms: (a) one-stage bilateral thoracic sympathectomy (control arm); or (b) unilateral thoracic sympathectomy in dominant side (intervention arm). At six months the participants submitted to unilateral procedure can make the contralateral surgery if they wanted it, creating a third group called two-stage bilateral sympathectomy. Participants will be evaluated for the degree of sweating by the Hyperhidrosis Disease Severity Scale (HDSS) and of quality of life questionnaires. Results 96 participants out of the 200 proposed have been included so far, with 48 participants randomized to each arm. From the sample 61 (63.5%) are female, with a mean age of 24 (20–32) years. There were exclusive palmar hiperhydrosis in 14 cases (14.5%), palmar and plantar hyperhidrosis in 36 (37.5%) cases, palmar and axillar hyperhidrosis in 12 (12,5%) cases and palmar-axillary-plantar hyperhidrosis in 34 (35,4%) cases. The age at the beginning of the disease was childhood (78%), with mean of time of disease 15 (11–22) years. Conclusions If one or both hypothesis: (a) unilateral sympathectomy in dominant hand is a satisfactory treatment; b) two-stage bilateral sympathectomy causes less compensatory sweating than in one stage are confirmed there is a chance that surgical therapy for palmar hyperhidrosis can be changed for better.

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Quality of life after thoracic sympathectomy for palmar hyperhidrosis: a meta-analysis

Wei

2020

Gen Thorac Cardiovasc Surg

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Number of Preoperative Hyperhidrosis Sites Does Not Affect the Sympathectomy Postoperative Results and Compensatory Hyperhidrosis Occurrence

Abstract: Patients with more than one preoperative hyperhidrosis site present worse quality of life prior to surgery than those with a single hyperhidrosis site, but the number of hyperhidrosis sites before surgery does not affect surgery outcomes.

Cited by 10 publications

References 29 publications

Does the Sweating Severity of Primary Hyperhidrosis Sites Affect Post-Sympathotomy Results?

Does the Sweating Severity of Primary Hyperhidrosis Sites Affect Post-Sympathotomy Results?

A prospective controlled randomized multicenter study to evaluate the severity of compensatory sweating after one-stage bilateral thoracic sympathectomy versus unilateral thoracic sympathectomy in the dominant side

Quality of life after thoracic sympathectomy for palmar hyperhidrosis: a meta-analysis

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