Document Detail

Evaluation of plantar hyperhidrosis in patients undergoing video-assisted thoracoscopic sympathectomy.
MedLine Citation:
PMID:  17565429     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Sympathectomy is the treatment of choice for primary hyperhidrosis. One curious occurrence that is difficult to explain from an anatomophysiological point of view in cases of video-assisted thoracoscopic sympathectomy (VATS) for the treatment of palmar hyperhidrosis (PH) is the observed improvement in plantar hyperhidrosis (PLH). Nevertheless, current reports on VATS rarely describe the effect on PLH or just give superficial data. The aim of this study was to prospectively investigate, how surgery affects PLH in patients with PH and PLH over one-year period. METHODS: From May 2003 to January 2004, 70 consecutive patients with combined PH and PLH underwent VATS at the T2, T3, or T4 ganglion level (47 women and 23 men, with mean age of 23 years). RESULTS: Immediately after the operation, all the patients said they were free from PH episodes, except for two patients (2.8%) who suffered from continued PH. Compensatory hyperhidrosis (CH) of various degrees was observed in 58 (90.6%) patients after one year. Only 13 (20.3%) suffered from severe CH. There was a great initial improvement in PLH in 50% of the cases, followed by progressive regression, such that only 23.4% still presented that improvement after one year. The number of cases without overall improvement increased progressively (from 17.1% to 37.5%) and the numbers with slight improvement remained stable (32.9-39.1%). Of the 24 patients with no improvement after one year, 6 patients graded plantar sweating worse. CONCLUSION: Patients with PH and PLH who undergo VATS to treat their PH present a good initial improvement in PLH that reduces to a lower level of improvement after the one-year period.
Nelson Wolosker; Guilherme Yazbek; José Ribas Milanez de Campos; Paulo Kauffman; Augusto Ishy; Pedro Puech-Leão
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Publication Detail:
Type:  Journal Article     Date:  2007-06-12
Journal Detail:
Title:  Clinical autonomic research : official journal of the Clinical Autonomic Research Society     Volume:  17     ISSN:  0959-9851     ISO Abbreviation:  Clin. Auton. Res.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-07-03     Completed Date:  2007-08-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9106549     Medline TA:  Clin Auton Res     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  172-6     Citation Subset:  IM    
Dept. of Vascular and Endovascular Surgery, Hospital das Clínicas School of Medicine, University of São Paulo, São Paulo, Brazil.
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MeSH Terms
Foot / physiopathology
Hand / physiopathology
Hyperhidrosis / physiopathology,  surgery*
Prospective Studies
Thoracic Surgery, Video-Assisted*
Time Factors
Treatment Outcome

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