Treatment of compensatory hyperhidrosis of the trunk with radiofrequency ablation

Deniz, Süleyman; Kavakli, Kuthan; Çaylak, Hasan; Purtuloglu, Tarik; Sapmaz, Ersin; İnangil, Gökhan; Atım, Abdülkadir; Gürkök, Sedat; Kurt, Ercan

doi:10.5505/agri.2015.37167

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…We assumed that CH occurs though the remaining sympathetic chains from the hypothalamic reflex arc. This assumption was reasonably demonstrated in some studies, which showed that CH was limited in the lower body when sympathicotomy was expanded to R7 and thoracic sympathicotomy improved CH in the trunk when CH developed after sympathicotomy (10,28,29). Therefore, we designed an expanded sympathicotomy technique to reduce CH.…”

Section: Discussionmentioning

confidence: 74%

“…In regard to safety of the expanded sympathicotomy, the sympathetic chain can be injured in the lower thorax when a severe adhesion is dissected in thoracic surgery or when an extrapleural procedure or pleurectomy is performed; however, no major complications have not been reported due to injury of the sympathetic chains in the lower thorax, except for the splanchnic nerve (30). In addition, the level of sympathicotomy ranged from R1 to R8 in a few studies (10,28,29). Because of these, we assumed that the sympathetic chain in the lower thorax could be cauterized without any major complications.…”

Section: Discussionmentioning

confidence: 99%

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New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis

Han

Kim

et al. 2020

J Thorac Dis

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Background: Primary hyperhidrosis (PH) is characterized by excessive and uncontrollable secretion in the eccrine sweat glands of the craniofacial region, armpits, hands, and feet. Sympathicotomy is the most effective treatment for severe PH; however, compensatory hyperhidrosis (CH) remains the most devastating postoperative complication. The purpose of the present study was to suggest a new sympathicotomy method for PH to prevent severe CH. Methods: From March 2014 to December 2018, a total of 212 patients were included in the study. R2 (53 cases) sympathicotomy for craniofacial hyperhidrosis and R3 (79 cases) or R4 (80 cases) sympathicotomy for palmar hyperhidrosis using the thoracoscopic technique were performed, respectively. Sympathicotomy was performed using two different methods (conventional 145 cases and new 67 cases). Expanded sympathicotomy was performed as the new method (67 cases), which was divided into two groups (partialand full-expanded sympathicotomy). Operative effectiveness was evaluated by a reduction in percentage of post-operative sweating compared with pre-operative sweating and groups were divided into complete and incomplete sweat reduction characteristics. Complete sweat reduction was defined as sweat reduction ≥80% compared with preoperative sweating. The degrees of CH were classified as negligible, mild bothering (tolerable), and severe bothering (intolerable). Data on preoperative subject characteristics, disease status, operative technique, and postoperative outcomes were gathered using medical records and telephone surveys. Results: According to sympathicotomy techniques, the conventional procedure (non-expanded sympathicotomy) was performed in 145 cases and the new expanded sympathicotomy procedure was performed in 67 cases (partial-expanded sympathicotomy 28 cases; full-expanded sympathicotomy 39 cases). Craniofacial hyperhidrosis was significantly more prevalent in the older group and in female patients (P<0.001 and P=0.007, respectively). Sympathicotomy was significantly more effective in palmar hyperhidrosis than craniofacial hyperhidrosis (P<0.001). CH was significantly more severe in craniofacial hyperhidrosis than palmar hyperhidrosis after sympathicotomy (P<0.001). In craniofacial hyperhidrosis, there was no significant difference in sweat reduction and CH between conventional and the expanded sympathicotomy techniques (P=0.177 and P=0.474, respectively). In palmar hyperhidrosis, there was no significant difference in sweat reduction between the conventional and the expanded sympathicotomy (P=0.178), however, degree of CH in the conventional technique was significantly more severe than in the expanded technique (P=0.001).Regarding comparison between partial-and full-expanded sympathicotomy, there was no significant difference in sweat reduction between partial-, and full-expanded sympathicotomy; however, CH was significantly more severe in partial-expanded sympathicotomy (craniofacial hyperhidrosis P=0.006; palmar hyperhidrosis P<0.001). Irrespective of hyperhidrosis types,...

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis

Han

Kim

et al. 2020

J Thorac Dis

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“…[ 10 , 11 ] Many recent studies aimed to explore various interventions to relieve the severe symptoms of hyperhidrosis by disruption of the targeted ganglia, either surgical or by laser photocoagulation. [ 12 , 13 ]…”

Section: Discussionmentioning

confidence: 99%

Patients’ satisfaction after bilateral thoracoscopic sympathicolysis

Hemead

Etman

Hemead

et al. 2023

Journal of Minimal Access Surgery

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Background: Palmar hyperhidrosis is a distressing condition implicating individuals’ social life and self-esteem. Surgery has proven to be highly effective with excellent safety profile. However, compensatory hyperhidrosis (CH), a relatively common adverse event of the procedure, is sometimes problematic in a few patients. Patients and Methods: A questionnaire, including Hyperhidrosis Disease Severity Scale (HDSS), was designed to assess the overall satisfaction of patients who underwent bilateral endoscopic thoracic sympathectomy between November 2018 and July 2021. They were requested to respond to the questionnaire before surgery and during the follow-up visits. Results: Sixty-three patients were recruited, 37 males and 26 females. The age of the participants ranged from 6 to 27 years (mean 17.05 ± 5.55 years). Most patients reported a positive impact on their professional and social life. Two patients experienced significant compensatory hyperhydrosis impacting their daily life. There was a significant improvement of the HDSS score after surgery. Around 95.2% of the participants (n = 60) had three-point improvement indicating 80% reduction of sweat production. Conclusion: : Bilateral endoscopic thoracoscopic sympathectomy has shown a high success rate with low adverse events. CH, however, remains a significant cause of morbidity in few patients. Therefore, continuous evaluation of patients’ satisfaction is of utmost importance to help improve our understanding to risk factors and prevalence of CH, improve our techniques to minimise its occurrence and treat patients with distressing symptoms. These data will guide surgeons when counselling patients to make insightful decisions based on the benefits and risks of the procedure.

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“…The severe hyperhidrosis in the trunk and hands interfered with the patient's everyday activities, and medical treatment failed, leading to the selection of surgical sympathetic blockade for treatment. Trunk is innervated by ipsilateral sympathetic efferent fibers from segments T4 to T12 (2) and previous studies have reported successful management in the trunk with sympathetic blockade (T4-T7) via ablation or botulinum toxin (1,3,6,8). We think that the ranges of sympathotomy for truncal compensatory hyperhidrosis are not defined yet.…”

Section: Discussionmentioning

confidence: 99%

“…However, postoperative compensatory hyperhidrosis is a challenging complication that can cause patients to regret undergoing surgery and lead to a surgeon's reluctance to choose surgery as the first treatment option for primary hyperhidrosis, especially craniofacial hyperhidrosis (1,3). Compensatory hyperhidrosis most commonly affects the trunk after sympathetic blockades (5,6). Herein, we present a rare case of a successful sympathotomy for severe compensatory hyperhidrosis in the trunk caused by traumatic cervical spinal cord injury.…”

Section: Introductionmentioning

confidence: 99%

Sympathotomy for severe compensatory hyperhidrosis in the trunk due to traumatic cervical spinal cord injury

et al. 2020

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Treatment of compensatory hyperhidrosis of the trunk with radiofrequency ablation

Cited by 5 publications

References 15 publications

New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis

New sympathicotomy for prevention of severe compensatory hyperhidrosis in patients with primary hyperhidrosis

Patients’ satisfaction after bilateral thoracoscopic sympathicolysis

Sympathotomy for severe compensatory hyperhidrosis in the trunk due to traumatic cervical spinal cord injury

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