Optimal targeting of sympathetic chain levels for treatment of palmar hyperhidrosis: an updated systematic review

Sang, Hongshi; Li, Guoliang; Xiong, Ping; Zhu, Mark; Zhu, Min

doi:10.1007/s00464-017-5508-y

Cited by 21 publications

(15 citation statements)

References 103 publications

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“…Also, disruption just cranial to the third rib produces the highest success rate in treating primary palmar and craniofacial hyperhidrosis. In another systematic review, the authors found that T2-free interventions lowered the risk of Horner's syndrome without compromising efficacy [ 18 ]. However, these conclusions are all based on retrospective reports, mainly in the adult population, and should be validated in prospective controlled trials.…”

Section: Discussionmentioning

confidence: 99%

Over a decade of single-center experience with thoracoscopic sympathicolysis for primary palmar hyperhidrosis: a case series

Mol¹,

Muensterer

2020

Surg Endosc

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Background Primary palmar hyperhidrosis is a severely debilitating condition that can affect patients of any age. We report our experience with thoracoscopic sympathicolysis in a large cohort of children less than 14 years of age. Methods All children who underwent thoracoscopic sympathicolysis from April 2005 through January 2017 were evaluated retrospectively. The procedure entailed bilateral bipolar fulguration of the second and third thoracic ganglia with transverse disruption of collateral nerve fibers along the third and fourth rib. Demographic information, as well as postoperative outcome, complications, and satisfaction were analyzed. Results Over the 12 year study interval, a total of 102 children underwent thoracoscopic sympathicolysis for palmar hyperhidrosis. Complete follow-up was available for 98 patients (median age 12 [range 5–14] years; 38 boys [39%]). Median follow-up was 4 [range 2–12] years. Complete palmar dryness was achieved in 93 (95%) cases. One patient suffered postoperative unilateral ptosis, 6 reported gustatory sweating, and 65 experienced compensatory sweating. Average postoperative rating on a 1 (lowest) to 10 (highest) rating scale was 9, with 97 (99%) patients saying that they would undergo the procedure again. Conclusion Our technique of thoracoscopic sympathicolysis in children was associated with very high postoperative satisfaction, despite a high rate of compensatory sweating and occasional autonomic gustatory sweating. Other more severe complications in this age group were rare.

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Section: Discussionmentioning

confidence: 99%

Over a decade of single-center experience with thoracoscopic sympathicolysis for primary palmar hyperhidrosis: a case series

Mol¹,

Muensterer

2020

Surg Endosc

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“…While others believed that the extent of resection had no effect on the occurrence of CH (23,24). Although plenty of studies have paid attention to the sympathetic levels (25)(26)(27)(28), the optimal sympathetic levels are still controversial. To determine which sympathetic surgical technique makes the lowest incidence of CH after surgery, we performed this meta-analysis.…”

Section: Commentsmentioning

confidence: 99%

Compensatory hyperhidrosis after different surgeries at the same sympathetic levels: a meta-analysis

Du¹,

Zhu²,

Wang³

et al. 2018

Ann. Transl. Med

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“…The clinical implication of this study is that with the high incidence of CS reported in this study and our previous study, 17 which can be associated with the involvement of T2 resection, it may be proposed to our institute regarding reducing ETS surgery that involves T2 resection. This suggestion is backed by the literature, which claims that symptom resolution was not significantly different between T2-involved and T2-spared group, but incidence of CS was significantly higher in the T2-involved group 26,36 . In addition, the expert consensus 35 of The Society of Thoracic Surgeons also supported the idea that ETS should avoid involving the T2 level as it may result in more complications and significantly higher risk of CS.…”

Section: Discussionmentioning

confidence: 92%

“…In our centre, majority of BETS were performed at a level of T2-T3 (78.3%), the frequency reported is summarised in Table 3. A T2 level has been well recognised to increase the risk of CS and other complications if interrupted 26,27 . Hence, we further categorise patients into T2-involved and T2-spared group to study the difference between both groups.…”

Section: Level Of Sympathectomymentioning

confidence: 99%

Does endoscopic thoracic sympathectomy improve the quality of life of patients with primary hyperhidrosis? A single center retrospective review

et al. 2021

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Background: Endoscopic thoracic sympathectomy (ETS) is renowned as an effective surgical treatment for primary hyperhidrosis (PHH) and believed to improve patients’ quality of life (QOL). This study aimed to evaluate the quality of life (QOL) of patients with PHH after ETS compared to before ETS, and to determine whether compensatory sweating (CS) affects QOL of patients. Methods: This is a single-centre retrospective review of patients who had undergone ETS at the National Heart Center [Institut Jantung Negara (IJN)], Malaysia. In total, 62 patients from January 2014 to December 2018 were recruited. Medical records were first reviewed for all relevant data, prior to making telephone interview to administer the questionnaire. A modified questionnaire with validated components was used to assess the patients’ QOL. Patient satisfaction, symptom resolution, recurrence and occurrence of CS were also asked during the interview. Data were analysed using IBM SPSS Statistics 25.0. Results: A total of 46 patients (response rate: 74.2%) completed the questionnaire, with 95.7% reporting improvement in the total QOL score (Mean difference = 113.54, SD=70.79, 95% CI = 95.52 – 134.57, p<0.001). There was remarkable symptom resolution for palmar HH as 97.8% reported dry hands, whereas majority of patients with palmar-plantar HH reported persistent sweating from feet HH. CS rate was 89.1%. In terms of severity of CS, 6 (14.6%) reported mild, 17 (41.5%) moderate, and 18 (43.9%) had severe CS. The severity of CS as well as the number of locations have a significant effect on the QOL reported (p=0.022 and p=0.008, respectively). Conclusion: ETS is an effective treatment for PHH in improving the QOL of patients, even long term. The occurrence of CS did not affect the QOL, but severity of CS and number of locations involved in CS affect the QOL of patients.

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Optimal targeting of sympathetic chain levels for treatment of palmar hyperhidrosis: an updated systematic review

Cited by 21 publications

References 103 publications

Over a decade of single-center experience with thoracoscopic sympathicolysis for primary palmar hyperhidrosis: a case series

Over a decade of single-center experience with thoracoscopic sympathicolysis for primary palmar hyperhidrosis: a case series

Compensatory hyperhidrosis after different surgeries at the same sympathetic levels: a meta-analysis

Does endoscopic thoracic sympathectomy improve the quality of life of patients with primary hyperhidrosis? A single center retrospective review

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