Surgical treatment of primary palmar hyperhidrosis: a prospective randomized study comparing T3 and T4 sympathicotomy

Liu, Yanguo; Yang, Jie; Li, Jun; Yang, Fan; Jiang, Guanchao; Li, Jianfeng; Huang, Yuqing; Wang, Jun

doi:10.1016/j.ejcts.2008.10.048

Cited by 88 publications

(78 citation statements)

References 23 publications

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“…Excessively dry hands are also a cause for dissatisfaction since they are an inconvenience for daily life activities. Liu et al claimed that it is important to maintain a slight degree of moisture in the hands because excessively dry hands decrease the degree of patient satisfaction [13]. In the present study, some patients complained of excessively dry hands, which likely influenced our finding of no correlation between the postoperative palmar sweating score and the degree of patient satisfaction.…”

Section: Discussioncontrasting

confidence: 54%

Extent of sympathectomy affects postoperative compensatory sweating and satisfaction in patients with palmar hyperhidrosis

et al. 2013

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Section: Discussioncontrasting

confidence: 54%

Extent of sympathectomy affects postoperative compensatory sweating and satisfaction in patients with palmar hyperhidrosis

et al. 2013

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“…[1,2,5,[11][12][13][14][15][16][17][18][19][20][21][22] In some studies, patient dissatisfaction because of CH was reported in 50-97% of patients. [5,28] As there is no solution for CH, the problem becomes more complex.…”

Section: Discussionmentioning

confidence: 99%

“…[1,5,11,12] The preferred surgical sympathectomy levels in palmar hyperhidrosis are T2, T3, T2-3, T4, T3-4. [1,2,5,[11][12][13][14][15][16][17][18][19][20][21][22] From the first introduction of surgical sympathectomy in the literature, the researches are continuing to find the most effective level with least complications. [1,2,5,[13][14][15][16][17][18][19][20] Recent researches have advocated the surgical sympathectomy of T4 sympatheic truncus has lesser adverse effects with better patient satisfaction rates.…”

Section: Introductionmentioning

confidence: 99%

“…[1,2,5,[13][14][15][16][17][18][19][20] Recent researches have advocated the surgical sympathectomy of T4 sympatheic truncus has lesser adverse effects with better patient satisfaction rates. [1,5,[13][14][15][18][19][20] However, there is need for additional studies.…”

Section: Introductionmentioning

confidence: 99%

“…[5] The most recommended technique is videoscopic thoracoscopic sympathectomy. [5,[11][12][13][14][15][16][17][18][19][20] Surgical techniques have some potential complications such as pneumothorax, hemothorax, atelectasia, Horner syndrome, compensatory hyperhidrosis (CH), excessive dryness, bradycardia and cardiac arrest. [1,5,11,12] The preferred surgical sympathectomy levels in palmar hyperhidrosis are T2, T3, T2-3, T4, T3-4.…”

Section: Introductionmentioning

confidence: 99%

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A New Target of Percutaneus Sympathic Radiofrequency Thermocoagulation for Treatment of Palmar Hyperhidrosis: T4

Purtuloglu¹,

Deniz²,

Atım³

et al. 2013

Agri

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SummaryObjectives: Hyperhidrosis is thought to result from a functional impairment of the sympathic nervous system. In this study, percutaneous T4 sympathic radiofrequency (RF) thermocoagulation was used to treat palmar hyperhidrosis which does not respond to conservative treatment. The results were evaluated in terms of safety, efficiency and patient satisfaction. Methods:In this study, 15 patients aged 16-48 years were retrospectively evaluated from prior records. Patient satisfaction scores (very satisfied, satisfied, not satisfied), after treatment of the hand condition (dry, mild dry, no improvement), and whether the most common complication and most patients expressed by the compensatory hyperhidrosis (CH) degree (none, mild, moderate, severe) were analyzed. Results:No complications were observed except a coughing crisis that lasted for 2 hours in one patient, transient bradycardia in 1 patient and transient injection site pain in all cases. Two patients 1 per week and three patients 1, 2 and 6 months developed recurrence.Conclusion: Sympathic T4 ablation with RF thermocoagulation was found to have long term (6 months) patient satisfaction (80%). It was also effective in reducing the hand sweating (80% dry or mild dry). The CH rate was 27%. According to our results, sympathic T4 ablation with RF thermocoagulation is a safe and effective treatment with a high degree of patient satisfaction.

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Reversal of thoracic sympathectomy through robot‐assisted microsurgical sympathetic trunk reconstruction with sural nerve graft and additional end‐to‐side coaptation of the intercostal nerves: A case report

et al. 2021

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Thoracic sympathectomy to treat palmar hyperhidrosis (PH) has widely been performed.Many patients regret the surgery due to compensatory hyperhidrosis (CH), gustatory hyperhidrosis, arrhythmia, hypertension, gastrointestinal disturbances, and emotional distress. Robotic applications in microsurgery are very limited. We report the technique and long-term patient-reported outcomes of bilateral robot-assisted microsurgical sympathetic trunk reconstruction with a sural nerve graft in an interdisciplinary setting. A 59-year-old female suffered from severe adverse effects after endoscopic thoracic sympathectomy (ETS) for PH 25 years ago. She reported CH over the whole trunk, gustatory hyperhidrosis, excessive dry hands, and emotional distress. An interdisciplinary surgical team performed a bilateral sympathetic trunk reversal reconstruction with an interpositional sural nerve graft per side by a da Vinci ® Robot. The nerve graft was microsurgically coapted using 9-0 sutures end-to-end to the sympathetic trunk stumps and side-to-end to the intercostal nerves T2-T4. At 24, 33 and 42 months, palmar dryness and emotional distress were strongly reduced. A highly specialized interdisciplinary setting may provide a precise, safe, and efficient treatment for ETS sequelae. A clinical study is initiated to validate this new therapy.

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Surgical treatment of primary palmar hyperhidrosis: a prospective randomized study comparing T3 and T4 sympathicotomy

Abstract: T3 and T4 sympathicotomies are both effective for the treatment of PH. T4 sympathicotomy, decreases the side effects but do not compromise the therapeutic effects, and should be the method of choice.

Cited by 88 publications

References 23 publications

Extent of sympathectomy affects postoperative compensatory sweating and satisfaction in patients with palmar hyperhidrosis

Extent of sympathectomy affects postoperative compensatory sweating and satisfaction in patients with palmar hyperhidrosis

A New Target of Percutaneus Sympathic Radiofrequency Thermocoagulation for Treatment of Palmar Hyperhidrosis: T4

Reversal of thoracic sympathectomy through robot‐assisted microsurgical sympathetic trunk reconstruction with sural nerve graft and additional end‐to‐side coaptation of the intercostal nerves: A case report

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