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Sympathectomy in the treatment of hyperhidrosis: Is it an effective solution?

Year 2024, , 9 - 13, 30.04.2024
https://doi.org/10.58651/jomtu.1421646

Abstract

Background: Primary hyperhidrosis affects 1-3% of the general population and occurs equally in both genders. It significantly affects the quality of life. In recent years, endoscopic thoracic sympathectomy (ETS), especially with a single-port approach, has gained popularity in the treatment of primary hyperhidrosis. This study aims to assess the efficacy and clinical outcomes of ETS surgery for primary hyperhidrosis.
Materials and Methods: The data of 30 patients who underwent bilateral ETS due to primary hyperhidrosis were examined retrospectively. 25 patients treated with a single port approach were included in the study, and 5 patients treated with a double port approach were excluded from the study. Preoperative evaluations and routine tests were performed. Patients were evaluated in terms of age, gender, complications, satisfaction, compensatory sweating, and relapse. Patients' satisfaction levels were determined by telephone interviews.
Results: The mean patient age was 24.16 ± 6.01 years; 56% were men and 44% were women. As complications, compensatory hyperhidrosis was observed in 12% of the patients, and mild pneumothorax was observed in 12%. No operative mortality occurred. No recurrence was observed during the long-term follow-up. In telephone surveys, 88% of patients reported satisfaction. Three patients with compensatory sweating were partially satisfied. No patient reported regret.
Conclusions: We believe that ETS is an effective option in the treatment of primary hyperhidrosis, with low morbidity and high patient satisfaction rates, despite the risk of compensatory sweating.

References

  • Chen, Y. B., Ye, W., Yang, W. T., Shi, L., Guo, X. F., Xu, Z. H., et al. (2009). Uniportal versus biportal video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis. Chinese Medical Journal, 122(13), 1525-1528.
  • Dewey, T. M., Herbert, M. A., Hill, S. L., Prince, S. L., & Mack, M. J. (2006). One-year follow-up after thoracoscopic sympathectomy for hyperhidrosis: outcomes and consequences. Annals of Thoracic Surgery, 81(4), 1227-1232.
  • Görür, R., Yıldızhan, A., Türüt, H., Şen, H., Yiyit, N., Candaş, F., et al. (2009). Analysis of 530 sympathectomy operations performed for palmar hyperhidrosis and long-term results. Turkish Journal of Thoracic and Cardiovascular Surgery, 17(1), 28-32.
  • Hashmonai, M., & Kopelman, D. (2003). History of sympathetic surgery. Clinical Autonomic Research, 13(1), 16-19.
  • Kaplan, T., Ekmekçi, P., Koçer, B., & Han, S. (2015). Bilateral sympathicotomy for hyperhidrosis without using single-lung ventilation. Turkish Journal of Medical Sciences, 45(4), 771-774.
  • Ng, T., & Milman, S. (2018). For sympathectomy, age is just a number. Journal of Thoracic and Cardiovascular Surgery, 156(4), 1757-1758.
  • Nicolini, E. M., Costa, V. O., Montessi, J., Rodrigues, G. A., Cangussu, V. V., Reis, A. F. M., & Marques Filho, F. V. (2019). Video-assisted thoracic sympathectomy: literature review. Revista do Colégio Brasileiro de Cirurgiões, 46(2), 2157.
  • Ocakcioglu, I. (2019). Single-Port Bilateral Endoscopic Thoracic Sympathectomy For The Treatment of Hyperhidrosis. Van Medical Journal, 26(1), 97-102.
  • Ravendran, K., Babu, B., Madouros, N., & Panagiotopoulos, N. (2023). Robotic sympathectomy for hyperhidrosis. Cureus, 15(1), e33885.
  • Raveglia, F., Orlandi, R., Guttadauro, A., Cioffi, U., Cardillo, G., Cioffi, G., & Scarci, M. (2021). How to prevent, reduce, and treat severe post sympathetic chain compensatory hyperhidrosis: state of the art. Frontiers in Surgery, 8, 814916.
  • Robertson, A. G., Russell, A. M., & Kirk, A. J. B. (2006). Endoscopic thoracic sympathectomy: a review. European Journal of Plastic Surgery, 29(2), 73-78.
  • Schmidt, J., Bechara, F. G., Altmeyer, P., & Zirngibl, H. (2006). Endoscopic thoracic sympathectomy for severe hyperhidrosis: impact of restrictive denervation on compensatory sweating. Annals of Thoracic Surgery, 81(3), 1048-1055.
  • Shanthanna, H., Aboutouk, D., Poon, E., Cheng, J., Finley, C., Paul, J., et al. (2016). A retrospective study of open thoracotomies versus thoracoscopic surgeries for persistent postthoracotomy pain. Journal of Clinical Anesthesia, 35(2), 215-220.
  • Toolabi, K., Parsaei, R., Farid, R., & Zamanian, A. (2022). Endoscopic thoracic sympathotomy for primary hyperhidrosis: predictors of outcome over a 10-year period. Surgical Endoscopy, 36(5), 3585-3591.
  • Whitson, B. A., Andrade, R. S., Dahlberg, P. S., & Maddaus, M. A. (2007). Evolution of clipping for thoracoscopic sympathectomy in symptomatic hyperhidrosis. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 17(4), 287-290.
  • Wolosker, N., Milanez de Campos, J. R., & Fukuda, J. M. (2016). Management of compensatory sweating after sympathetic surgery. Thoracic Surgery Clinics, 26(4), 445-451.

Hiperhidroz tedavisinde sempatektomi: Etkin bir çözüm yolu mu?

Year 2024, , 9 - 13, 30.04.2024
https://doi.org/10.58651/jomtu.1421646

Abstract

Amaç: Primer hiperhidrozis, genel popülasyonun %1-3'ünü etkiler ve her iki cinsiyette de eşit oranda görülür. Yaşam kalitesini önemli ölçüde etkilemektedir. Son yıllarda, özellikle tek port yaklaşımıyla endoskopik torasik sempatektomi (ETS), primer hiperhidrozisin tedavisinde popülerlik kazanmıştır. Bu çalışma primer hiperhidrozisde ETS ameliyatının etkinliğini ve klinik sonuçlarını değerlendirmeyi amaçlamaktadır.
Materyal ve Metot: Primer hiperhidrozis nedeniyle iki taraflı ETS uygulanan 30 hastanın verileri geriye dönük olarak incelendi. Çalışmaya tek port yaklaşımıyla tedavi edilen 25 hasta dahil edildi, çift port uygulanan 5 hasta çalışma dışı bırakıldı. Ameliyat öncesi değerlendirmeler ve rutin testler yapıldı. Hastalar yaş, cinsiyet, komplikasyonlar, memnuniyet, kompansatuvar terleme ve nüks açısından değerlendirildi. Hastaların memnuniyet düzeyleri telefon görüşmesi ile belirlendi.
Bulgular: Ortalama hasta yaşı 24,16 ± 6,01 idi; %56'sı erkek ve %44'ü kadındı. Komplikasyon olarak hastaların %12’sinde kompansatris hiperhidrozis ve %12’sinde hafif pnömotoraks görüldü. Operatif mortalite meydana gelmedi. Uzun süreli takipte herhangi bir nüks görülmedi. Telefon anketlerinde hastaların %88'i memnuniyet bildirdi. Kompansatuvar terleme olan üç hasta kısmen memnundu. Hiçbir hasta pişmanlık bildirmedi.
Sonuç: Primer hiperhidrozis tedavisinde kompansatuvar terleme riskine rağmen düşük morbidite ve yüksek hasta memnuniyet oranları ile ETS'nin etkili bir seçenek olduğuna inanıyoruz

References

  • Chen, Y. B., Ye, W., Yang, W. T., Shi, L., Guo, X. F., Xu, Z. H., et al. (2009). Uniportal versus biportal video-assisted thoracoscopic sympathectomy for palmar hyperhidrosis. Chinese Medical Journal, 122(13), 1525-1528.
  • Dewey, T. M., Herbert, M. A., Hill, S. L., Prince, S. L., & Mack, M. J. (2006). One-year follow-up after thoracoscopic sympathectomy for hyperhidrosis: outcomes and consequences. Annals of Thoracic Surgery, 81(4), 1227-1232.
  • Görür, R., Yıldızhan, A., Türüt, H., Şen, H., Yiyit, N., Candaş, F., et al. (2009). Analysis of 530 sympathectomy operations performed for palmar hyperhidrosis and long-term results. Turkish Journal of Thoracic and Cardiovascular Surgery, 17(1), 28-32.
  • Hashmonai, M., & Kopelman, D. (2003). History of sympathetic surgery. Clinical Autonomic Research, 13(1), 16-19.
  • Kaplan, T., Ekmekçi, P., Koçer, B., & Han, S. (2015). Bilateral sympathicotomy for hyperhidrosis without using single-lung ventilation. Turkish Journal of Medical Sciences, 45(4), 771-774.
  • Ng, T., & Milman, S. (2018). For sympathectomy, age is just a number. Journal of Thoracic and Cardiovascular Surgery, 156(4), 1757-1758.
  • Nicolini, E. M., Costa, V. O., Montessi, J., Rodrigues, G. A., Cangussu, V. V., Reis, A. F. M., & Marques Filho, F. V. (2019). Video-assisted thoracic sympathectomy: literature review. Revista do Colégio Brasileiro de Cirurgiões, 46(2), 2157.
  • Ocakcioglu, I. (2019). Single-Port Bilateral Endoscopic Thoracic Sympathectomy For The Treatment of Hyperhidrosis. Van Medical Journal, 26(1), 97-102.
  • Ravendran, K., Babu, B., Madouros, N., & Panagiotopoulos, N. (2023). Robotic sympathectomy for hyperhidrosis. Cureus, 15(1), e33885.
  • Raveglia, F., Orlandi, R., Guttadauro, A., Cioffi, U., Cardillo, G., Cioffi, G., & Scarci, M. (2021). How to prevent, reduce, and treat severe post sympathetic chain compensatory hyperhidrosis: state of the art. Frontiers in Surgery, 8, 814916.
  • Robertson, A. G., Russell, A. M., & Kirk, A. J. B. (2006). Endoscopic thoracic sympathectomy: a review. European Journal of Plastic Surgery, 29(2), 73-78.
  • Schmidt, J., Bechara, F. G., Altmeyer, P., & Zirngibl, H. (2006). Endoscopic thoracic sympathectomy for severe hyperhidrosis: impact of restrictive denervation on compensatory sweating. Annals of Thoracic Surgery, 81(3), 1048-1055.
  • Shanthanna, H., Aboutouk, D., Poon, E., Cheng, J., Finley, C., Paul, J., et al. (2016). A retrospective study of open thoracotomies versus thoracoscopic surgeries for persistent postthoracotomy pain. Journal of Clinical Anesthesia, 35(2), 215-220.
  • Toolabi, K., Parsaei, R., Farid, R., & Zamanian, A. (2022). Endoscopic thoracic sympathotomy for primary hyperhidrosis: predictors of outcome over a 10-year period. Surgical Endoscopy, 36(5), 3585-3591.
  • Whitson, B. A., Andrade, R. S., Dahlberg, P. S., & Maddaus, M. A. (2007). Evolution of clipping for thoracoscopic sympathectomy in symptomatic hyperhidrosis. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 17(4), 287-290.
  • Wolosker, N., Milanez de Campos, J. R., & Fukuda, J. M. (2016). Management of compensatory sweating after sympathetic surgery. Thoracic Surgery Clinics, 26(4), 445-451.
There are 16 citations in total.

Details

Primary Language English
Subjects Thoracic Surgery
Journal Section Research Articles
Authors

Özgür Katrancıoğlu 0000-0002-1669-417X

Şule Karadayı 0000-0002-6639-5709

Merve Karabacak 0000-0002-0515-1620

Publication Date April 30, 2024
Submission Date January 17, 2024
Acceptance Date April 1, 2024
Published in Issue Year 2024

Cite

APA Katrancıoğlu, Ö., Karadayı, Ş., & Karabacak, M. (2024). Sympathectomy in the treatment of hyperhidrosis: Is it an effective solution?. Journal of Medical Topics and Updates, 3(1), 9-13. https://doi.org/10.58651/jomtu.1421646