Document Detail


Endoscopic thoracic sympathectomy for severe hyperhidrosis: impact of restrictive denervation on compensatory sweating.
MedLine Citation:
PMID:  16488721     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Compensatory sweating is noted frequently after sympathectomy and may be difficult to control in some patients. This prospective trial was projected to measure the impact of limited denervation on compensatory sweating while performing endoscopic thoracic sympathectomy. METHODS: One hundred seventy-eight patients (127 female and 51 male) with severe primary hyperhidrosis unsuccessfully treated by conservative means entered the study. Group A was treated with sympathectomy from T2 to T4. In group B sympathectomy was performed from T3 to T5. Physical condition was measured after 1, 6, and 24 months by means of the SF-36 Health Survey Test. RESULTS: Evaluation rate was 94.9%. Horner's syndrome was not detected, recurrence rate was 0.6%, and rate of persistent pneumothorax was 2.3%. Compensatory sweating was reported with 17.1% in group A and diminished to 4.9% in group B. Gustatory sweating was comparable in both groups (4.3% versus 4.9%). Satisfaction rate was 97% in patients with palmar hyperhidrosis, 95% for axillary hyperhidrosis, and 87% for facial hyperhidrosis. Discomfort originating from compensatory sweating was less than symptoms from primary hyperhidrosis 24 months after endoscopic thoracic sympathectomy in more than 90%. Only 7.1% of the entire group was not satisfied. CONCLUSIONS: Our study demonstrates that limiting denervation beyond T2 ganglion offers good clinical results in axillary as well as palmar hyperhidrosis and may reduce the risk for compensatory sweating. In women, reduction was as high as 75% and in men, near 50%. Our impression is that severe compensatory sweating and the majority of stellate ganglion lesions occur as a result of starting sympathectomy at level T2.
Authors:
Johannes Schmidt; Falk Georges Bechara; Peter Altmeyer; Hubert Zirngibl
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  81     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-20     Completed Date:  2006-09-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1048-55     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Evangelisches Krankenhaus Lutherhaus, Essen, Germany. johannes.schmidt@lutherhaus.de
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Axilla
Cohort Studies
Denervation
Face
Female
Follow-Up Studies
Humans
Hyperhidrosis / surgery*
Male
Pain, Postoperative
Prospective Studies
Sweating / physiology
Sympathectomy*
Thoracic Surgical Procedures*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Gustatory side effects after thoracoscopic sympathectomy.
Next Document:  Echocardiography versus right-sided heart catheterization among lung transplantation candidates.