Retroperitoneoscopic lumbar sympathectomy for the treatment of primary plantar hyperhidrosis

Abstract

Background Primary plantar hyperhidrosis (PPH) is an idiopathic disease, characterized by excessive sweating of the feet. It leads to significant disturbance in private and professional daily lifestyle, due to excessive sweating. The aim of this study is to present the safety, efficacy and procedures of retroperitoneoscopic lumbar sympathectomy (RLS) for treatment of PPH. Methods RLS was performed 60 times in 30 patients (18 men, 12 women) with PPH in our institution from May 2019 to October 2020. All procedures were carried out by laparoscopy with retroperitoneal approach. Clinical data including patient demographics and perioperative, postoperative outcomes were evaluated. Recurrence of symptoms, and any adverse effects of surgery were evaluated after 7 to 30 days in outpatient clinic, and thereafter every 6 months. Results Mean age of patients was 33.6 (± standard deviation 10.8) years. Fourteen and fifteen patients were previously treated with medical therapy or endoscopic thoracic sympathectomy (ETS) respectively. Mean preoperative quality of life (QoL) score of patients was 91.8 (VERY BAD), but postoperative 12 months (QoL) score decreased to 29.1 (MUCH BETTER). There was no serious postoperative complication. During the mean 22 months of follow-up period, no compensatory sweating was observed. Conclusions RLS can be a safe and effective surgical treatment for severe PPH, especially for the patients with persistent plantar sweating even after conservative management and ETS. RLS also could be offered to surgeons who are familiar with retroperitoneal space anatomy as feasible surgical treatment for PPH.

The Impact of Hyperhidrosis on Quality of Life: A Review of the Literature

“…The mean decrease in QoL scores was − 42.0 points toward better QoL. Hur et al 2022 [ 21 ] HQLQ Pre-post interventional study 30 Mean pre-sympathectomy QoL score for patients with plantar HH was 91.8 (“very bad” QoL), and the postoperative 12 months (QoL) score improved to 29.1 (“much better” QoL). Zhang et al 2022 [ 22 ] HQLQ Pre-post interventional study 367 Median pre-sympathectomy QoL score for patients with plantar HH was 40, and postoperative 12 months (QoL) score improved to 20.…”