Thorac Cardiovasc Surg 2019; 67(05): 407-414
DOI: 10.1055/s-0038-1667317
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Number of Preoperative Hyperhidrosis Sites Does Not Affect the Sympathectomy Postoperative Results and Compensatory Hyperhidrosis Occurrence

Nelson Wolosker
1   Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, Morumbi, São Paulo, Brazil
2   Division of Vascular and Endovascular, Department of Surgery, Hospital das Clínicas da Faculdade de Medicina, Pinheiros, University of São Paulo School of Medicine, University of São Paulo, São Paulo, Brazil
,
Dafne Braga Diamante Leiderman
1   Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, Morumbi, São Paulo, Brazil
,
Jose Ribas Millanez de Campos
3   Division of Thoracic Surgery, Hospital Israelita Albert Einstein, Morumbi, São Paulo, Brazil
4   Division of Thoracic Surgery, Department of Surgery, University of São Paulo School of Medicine, University of São Paulo, Pinheiros, São Paulo, Brazil
,
Paulo Kauffman
1   Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, Morumbi, São Paulo, Brazil
2   Division of Vascular and Endovascular, Department of Surgery, Hospital das Clínicas da Faculdade de Medicina, Pinheiros, University of São Paulo School of Medicine, University of São Paulo, São Paulo, Brazil
,
Miguel Lia Tedde
4   Division of Thoracic Surgery, Department of Surgery, University of São Paulo School of Medicine, University of São Paulo, Pinheiros, São Paulo, Brazil
,
Guilherme Yazbek
5   Department of Vascular and Endovascular Surgery, A.C. Camargo Cancer Center, Fundação Antonio Prudente, São Paulo, Brazil
,
Pedro Puech-Leão
2   Division of Vascular and Endovascular, Department of Surgery, Hospital das Clínicas da Faculdade de Medicina, Pinheiros, University of São Paulo School of Medicine, University of São Paulo, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

22 May 2018

11 June 2018

Publication Date:
02 August 2018 (online)

Abstract

Background Patients with primary hyperhidrosis present with sweating in two or more sites in nearly 85% of cases. In this study, we examined whether the number of hyperhidrosis sites is related to the surgery outcomes.

Methods One hundred ninety-three hyperhidrosis patients who underwent bilateral videothoracoscopic sympathectomy after failure or dissatisfaction with clinical treatment were distributed into three groups based on the number of hyperhidrosis sites (one site, two sites, and three or more sites of hyperhidrosis). The primary endpoints in the study were as follows: quality of life prior to surgery, improvement of quality of life after surgery, clinical improvement of sweating, presence or absence of compensatory hyperhidrosis, and general satisfaction after 1 month of surgery.

Results Patients with two or more hyperhidrosis sites had worse quality of life before surgery than patients with a single hyperhidrosis site. There was an improvement in the quality of life in more than 95% of the patients, clinical improvement in more than 95% of patients, severe compensatory hyperhidrosis in less than 10%, and low general satisfaction after 1 month of surgery in only 2.60% of the patients, with no differences among the three groups.

Conclusions Patients with more than one preoperative hyperhidrosis site present worse quality of life prior to surgery than those with a single hyperhidrosis site, but the number of hyperhidrosis sites before surgery does not affect surgery outcomes.

Supplementary Material

 
  • References

  • 1 Estevan FA, Wolosker MB, Wolosker N, Puech-Leão P. Epidemiologic analysis of prevalence of the hyperhidrosis. An Bras Dermatol 2017; 92 (05) 630-634
  • 2 Wolosker N, Teivelis MP, Krutman M. , et al. Long-term results of oxybutynin treatment for palmar hyperhidrosis. Clin Auton Res 2014; 24 (06) 297-303
  • 3 Wolosker N, de Campos JRM, Kauffman P, de Oliveira LA, Munia MA, Jatene FB. Evaluation of quality of life over time among 453 patients with hyperhidrosis submitted to endoscopic thoracic sympathectomy. J Vasc Surg 2012; 55 (01) 154-156
  • 4 de Campos JRM, Wolosker N, Takeda FR. , et al. The body mass index and level of resection: predictive factors for compensatory sweating after sympathectomy. Clin Auton Res 2005; 15 (02) 116-120
  • 5 Neves S, Uchoa PC, Wolosker N. , et al. Long-term comparison of video-assisted thoracic sympathectomy and clinical observation for the treatment of palmar hyperhidrosis in children younger than 14. Pediatr Dermatol 2012; 29 (05) 575-579
  • 6 Wolosker N, Munia MAS, Kauffman P, Campos JR, Yazbek G, Puech-Leão P. Is gender a predictive factor for satisfaction among patients undergoing sympathectomy to treat palmar hyperhidrosis?. Clinics (Sao Paulo) 2010; 65 (06) 583-586
  • 7 Wolosker N, Yazbek G, de Campos JRM. , et al. Quality of life before surgery is a predictive factor for satisfaction among patients undergoing sympathectomy to treat hyperhidrosis. J Vasc Surg 2010; 51 (05) 1190-1194
  • 8 Ong W, Lee A, Tan WB, Lomanto D. Long-term results of a randomized controlled trial of T2 versus T2-T3 ablation in endoscopic thoracic sympathectomy for palmar hyperhidrosis. Surg Endosc 2016; 30 (03) 1219-1225
  • 9 Lee SS, Lee YU, Lee J-H, Lee JC. Comparison of the long-term results of R3 and R4 sympathicotomy for palmar hyperhidrosis. Korean J Thorac Cardiovasc Surg 2017; 50 (03) 197-201
  • 10 Wolosker N, de Campos JRM, Kauffman P, Puech-Leão P. A randomized placebo-controlled trial of oxybutynin for the initial treatment of palmar and axillary hyperhidrosis. J Vasc Surg 2012; 55 (06) 1696-1700
  • 11 de Andrade Filho LO, Kuzniec S, Wolosker N, Yazbek G, Kauffman P, Milanez de Campos JR. Technical difficulties and complications of sympathectomy in the treatment of hyperhidrosis: an analysis of 1731 cases. Ann Vasc Surg 2013; 27 (04) 447-453
  • 12 Amir M, Arish A, Weinstein Y, Pfeffer M, Levy Y. Impairment in quality of life among patients seeking surgery for hyperhidrosis (excessive sweating): preliminary results. Isr J Psychiatry Relat Sci 2000; 37 (01) 25-31
  • 13 Varella AYM, Fukuda JM, Teivelis MP. , et al. Translation and validation of Hyperhidrosis Disease Severity Scale. Rev Assoc Med Bras (1992) 2016; 62 (09) 843-847
  • 14 de Campos JRM, Kauffman P, Werebe Ede C. , et al. Quality of life, before and after thoracic sympathectomy: report on 378 operated patients. Ann Thorac Surg 2003; 76 (03) 886-891
  • 15 de Campos JRM, Kauffman P, Werebe EC. Questionnaire of quality of life in patients with primary hyperhidrosis. J Bras Pneumol 2003; 01: 171-181
  • 16 Yazbek G, Wolosker N, de Campos JRM, Kauffman P, Ishy A, Puech-Leão P. Palmar hyperhidrosis--which is the best level of denervation using video-assisted thoracoscopic sympathectomy: T2 or T3 ganglion?. J Vasc Surg 2005; 42 (02) 281-285
  • 17 Glaser DA, Ballard AM, Hunt NL, Pieretti LJ, Pariser DM. Prevalence of multifocal primary hyperhidrosis and symptom severity over time: results of a targeted survey. Dermatol Surg 2016; 42 (12) 1347-1353
  • 18 Turhan K, Cakan A, Cagirici U. Preserving T2 in thoracic sympathicotomy for palmar hyperhidrosis: less tissue trauma, same effectiveness. Thorac Cardiovasc Surg 2011; 59 (06) 353-356
  • 19 Gee S, Yamauchi PS. Nonsurgical management of hyperhidrosis. Thorac Surg Clin 2008; 18 (02) 141-155
  • 20 Baker DM. Topical glycopyrrolate reduces axillary hyperhidrosis. J Eur Acad Dermatol Venereol 2016; 30 (12) 2131-2136
  • 21 Pariser DM, Ballard A. Topical therapies in hyperhidrosis care. Dermatol Clin 2014; 32 (04) 485-490
  • 22 Grimalt R, Domínguez Tordera P, Callejas MA. Topical atropine sulfate for the treatment of axillary hyperhidrosis. J Cosmet Dermatol 2006; 5 (04) 294-296
  • 23 Talarico-Filho S, Mendonça DO Nascimento M, Sperandeo DE Macedo F, DE Sanctis Pecora C. A double-blind, randomized, comparative study of two type A botulinum toxins in the treatment of primary axillary hyperhidrosis. Dermatol Surg 2007; 33 (1 Spec No.(: S44-S50
  • 24 Vannucci F, Araújo JA. Thoracic sympathectomy for hyperhidrosis: from surgical indications to clinical results. J Thorac Dis 2017; 9 (Suppl. 03) S178-S192
  • 25 de Campos JRM, Lembrança L, Fukuda JM. , et al. Evaluation of patients who underwent resympathectomy for treatment of primary hyperhidrosis. Interact Cardiovasc Thorac Surg 2017; 25 (05) 716-719
  • 26 Bryant AS, Cerfolio RJ. Satisfaction and compensatory hyperhidrosis rates 5 years and longer after video-assisted thoracoscopic sympathotomy for hyperhidrosis. J Thorac Cardiovasc Surg 2014; 147 (04) 1160-1163.e1
  • 27 Shelley WB, Florence R. Compensatory hyperhidrosis after sympathectomy. N Engl J Med 1960; 263 (21) 1056-1058
  • 28 Wolosker N, Milanez de Campos JR, Fukuda JM. Management of compensatory sweating after sympathetic surgery. Thorac Surg Clin 2016; 26 (04) 445-451
  • 29 Aydemir B, Imamoglu O, Okay T, Celik M. Sympathectomy versus sympathicotomy in palmar hyperhidrosis comparing T3 ablation. Thorac Cardiovasc Surg 2015; 63 (08) 715-719
  • 30 Larson DL. Definitive diagnosis and management of axillary hyperhidrosis: the VapoMeter and suction-assisted arthroscopic shaving. Aesthet Surg J 2011; 31 (05) 552-559