Simpatectomia bilateral R5-R8 no tratamento de hiperidrose compensatória: análise de complicações e satisfação dos pacientes.

Vasconcelos, César Freire de Melo; Aguiar, Wolfgang Schmidt; Tavares, Rafael Melo; Barbosa, Alisson; Cordeiro, Gabriel Guerra; Santa‐Cruz, Fernando; Ferraz, Álvaro Antônio Bandeira

doi:10.1590/0100-6991e-20202398

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…In these studies the sympathectomy was performed without intraoperative monitoring of blood perfusion for determining the connections between ganglia and skin areas affected by CS. In these 2 studies the satisfaction rate was 45% for Moon ( 12 ) and 67% for Vasconcelos ( 13 ).…”

Section: Discussionmentioning

confidence: 96%

Surgical management of compensatory sweating: A systematic review

et al. 2023

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Endoscopic thoracic sympathectomy (ETS) surgery is a highly effective treatment of primary hyperhidrosis (PH) for the palms, face, axillae. Compensatory sweating (CS) is the most common and feared side effect of thoracic sympathectomy. CS is a phenomenon characterized by increased sweating in sites distal to the level of sympathectomy. Compensatory sweating is the main problem for which many patients give up surgery, losing the chance to solve their problem and accepting a poor quality of life. There are still no treatments that offer reliable solutions for compensatory sweating. The treatments proposed in the literature are scarce, with low case histories, and with uncertain results. Factors associated with CS are extension of manipulation of the sympathetic chain, level of sympathetic denervation, and body mass index. Therapeutic options include non surgical treatment and surgical treatment. Non surgical treatments include topical agents, botulinum toxin, systemic anticholinergics, iontophoresis. Surgical treatments include clip removal, extended sympathectomy and sympathetic chain reconstruction, although the efficacy is not well-established for all the methods. In this review we provide an overview of the treatments and outcomes described in the literature for the management of compensatory CS, with focus on surgical treatment.

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Section: Discussionmentioning

confidence: 96%

Surgical management of compensatory sweating: A systematic review

et al. 2023

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“…The mechanisms by which BS acts has already been studied in a number of experimental studies, but with few clinical information, precluding definitive conclusions about its potential benefits. The absence of severe complications and side effects in patients submitted to BS for treatment of ventricular arrhythmias ( 47 ) or hyperhidrosis ( 56 ) also does not exclude possible risks in HF patients. Randomized controlled trial in patients with HFrEF must be performed to fully assess the effects of thoracic BS and provide real evidence of its perspective as an alternative to the current treatments.…”

Section: Future Perspectivesmentioning

confidence: 99%

Perspectives of bilateral thoracic sympathectomy for treatment of heart failure

Silva¹,

Zanoni²,

Simas³

et al. 2021

Clinics

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Surgical neuromodulation therapies are still considered a last resort when standard therapies have failed for patients with progressive heart failure (HF). Although a number of experimental studies have provided robust evidence of its effectiveness, the lack of strong clinical evidence discourages practitioners. Thoracic unilateral sympathectomy has been extensively studied and has failed to show significant clinical improvement in HF patients. Most recently, bilateral sympathectomy effect was associated with a high degree of success in HF models, opening the perspective to be investigated in randomized controlled clinical trials. In addition, a series of clinical trials showed that bilateral sympathectomy was associated with a decreased risk of sudden death, which is an important outcome in patients with HF. These aspects indicates that bilateral sympathectomy could be an important alternative in the treatment of HF wherein pharmacological treatment barely reaches the target dose.

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T3-T5 Thoracoscopic sympathectomy versus sympathicotomy in the treatment of palmar–axillary–plantar hyperhidrosis

Mahmoud,

Allah Abd Elhady,

Mohamed

et al. 2023

The Egyptian Journal of Surgery

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Background Compensatory hyperhidrosis is a common complication after thoracoscopic interruption of the sympathetic chain in hyperhidrosis patients. Nonetheless, no interruption technique has been defined to decrease the incidence of that dreadful complication. Herein, we compared T3-5 sympathectomy with sympathicotomy at the same levels with regard to postoperative outcomes. Methods Eighty patients diagnosed with primary palmar–axillary–plantar hyperhidrosis were randomized into two equal groups: the sympathectomy and sympathicotomy groups. They were followed up for 6 months after the procedure. The incidence and criteria of compensatory hyperhidrosis were compared between the two approaches. Results The sympathectomy group showed a significant prolongation of the operative time. However, postoperative pain, hospital stay, and the incidence of complications were statistically comparable between the two approaches. Both procedures were associated with a significant decline in the severity of sweating in the three regions, which was more prominent in the palmar and axillary regions compared with the foot. The incidence of compensatory hyperhidrosis was 65% in sympathectomy patients and 77.5% in sympathicotomy patients, with no significant difference between them (P=0.217). About two-thirds of these cases were temporary, and the majority of them had mild to moderate symptoms. Patient satisfaction did not differ between the two approaches, with poor satisfaction in patients with permanent compensatory hyperhidrosis. Conclusion Both sympathectomy and sympathicotomy had comparable outcomes in patients with palmar–axillary–plantar hyperhidrosis, manifested in comparable decreased sweating severity, incidence of compensatory hyperhidrosis, quality of life, and patient satisfaction.

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Simpatectomia bilateral R5-R8 no tratamento de hiperidrose compensatória: análise de complicações e satisfação dos pacientes.

Cited by 3 publications

References 18 publications

Surgical management of compensatory sweating: A systematic review

Surgical management of compensatory sweating: A systematic review

Perspectives of bilateral thoracic sympathectomy for treatment of heart failure

T3-T5 Thoracoscopic sympathectomy versus sympathicotomy in the treatment of palmar–axillary–plantar hyperhidrosis

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