Long term compensatory sweating results after sympathectomy for palmar and axillary hyperhidrosis

Cecilia Menna, Mohsen Ibrahim, Claudio Andreetti, Anna Maria Ciccone, Antonio D'Andrilli, Giulio Maurizi, Camilla Poggi, Erino Angelo Rendina

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background: Endoscopic thoracic sympathectomy is currently the best treatment for primary upper extremity hyperhidrosis, but the potential for adverse effects, particularly the development of compensatory sweating, is a concern and often precludes surgery as a definitive therapy. This study aims to evaluate longterm results of two-stage unilateral versus one-stage bilateral thoracoscopic sympathectomy. Methods: From November 1995 to February 2011, 261 patients with severe palmar and/or axillary hyperhidrosis underwent endoscopic sympathectomy with a follow-up of at least 4 years. Onehundred and twenty-six patients received one-stage bilateral, single port video-assisted thoracoscopic sympathectomy (one-stage group) and 135 patients underwent two-stage unilateral, single-port videoassisted thoracoscopic sympathectomy, with a mean time interval of four months between the procedures (two-stage group). Results: The mean postoperative follow-up period was 7.2 years (range, 4-9 years). Sixteen patients (12.7%) in the one-stage group and 15 patients (11.1%) in the two-stage group suffered from bradycardia (P=0.15). Recurrences occurred in three patients (2.4%) in the one-stage group and one (0.7%) in the twostage group (P=0,09). Facial flushing or hyperthermia occurred in eight patients (6.3%) in the one-stage group and 11 (8.1%) of the two-stage group. Compensatory sweating occurred in 27 patients (21.4%) in the one-stage group and six patients (4.4%) in the two-stage group (P=0.0001). However, compensatory sweating recovered in five patients (83.3%) in the two-stage group versus nine (33.35%) in one-stage group during the follow-up period (Log-rank test P=0.016; HR, 7.196; 95% CI, 1.431-36.20). An improvement in postoperative quality of life (QoL) scores was observed in at least 90% of patients at three years after surgery in the one-stage group and at least 95% of patients in the two-stage group (P=0.001). Conclusions: Compensatory sweating seems to improve during the follow-up period with a higher recovery rate after two-stage unilateral versus one-stage bilateral sympathectomy for patients with palmar and axillary hyperhidrosis.

Original languageEnglish
Pages (from-to)26-32
Number of pages7
JournalAnnals of Cardiothoracic Surgery
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Compensatory sweating
  • Palmar and axillary hyperhidrosis
  • Video-assisted thoracoscopic sympathectomy

Fingerprint

Dive into the research topics of 'Long term compensatory sweating results after sympathectomy for palmar and axillary hyperhidrosis'. Together they form a unique fingerprint.

Cite this