Endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limbs. A critical analysis and long-term results of 480 operations.
نویسندگان
چکیده
OBJECTIVE This evaluated the long-term outcome after endoscopic thoracic sympathectomy (ETS) from below D1 to D4, using a single-site access technique for primary hyperhidrosis of the upper limbs. SUMMARY BACKGROUND DATA Primary hyperhidrosis of the upper limbs is a distressing and often socially disabling condition. Endoscopic thoracic sympathectomy is considered the treatment of choice, causing minimal morbidity and high initial success rates. However, data regarding long-term results are scarce. METHODS Two hundred seventy of 323 patients (83.7%), in whom 480 sympathectomies were performed, answered a questionnaire after a mean of 14.6 years postoperatively regarding the early postoperative result, side effects, and complications caused by the operation and long-term results with particular emphasis on patient satisfaction. RESULTS There was no postoperative mortality and no major complications requiring surgical reintervention. A majority of the patients (98.1%) were relieved, and 95.5% were satisfied initially. Permanent side effects included compensatory sweating in 67.4%, gustatory sweating in 50.7% and Horner's trias in 2.5%. However, patient satisfaction declined over time, although only 1.5% recurred. This left only 66.7% satisfied, and a 26.7% partially satisfied. Compensatory and gustatory sweating were the most frequently stated reasons for dissatisfaction. Individuals operated for axillary hyperhidrosis without palmar involvement were significantly less satisfied (33.3% and 46.2%, respectively).
منابع مشابه
Uniportal endoscopic thoracic sympathectomy for treatment of palmar and axillary hyperhidrosis: analysis of 2000 cases.
OBJECTIVE Primary hyperhidrosis of the upper limbs is a common and troublesome condition in Taiwan. Therefore, we present our experience in treating hyperhidrosis via uniportal endoscopic thoracic sympathectomy. METHODS Between April 1993 and March 2000, a total of 2000 patients underwent endoscopic thoracic sympathectomy for treatment of palmar or axillary hyperhidrosis. There were 1520 pati...
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controlled intradermal injection of botulinum toxin type A in recalcitrant axillary hyperhidrosis. J Am Acad Dermatol 1999;41:987-90. 8 Naumann M, Flachenecker P, Bröcker E-B, Toyka KV, Reiners K. Botulinum toxin for palmar hyperhidrosis. Lancet 1997;349:252. 9 Naumann M, Hofmann U, Bergmann I, Hamm H, Toyka KV, Reiners K. Focal hyperhidrosis: effective treatment with intracutaneous botulinum t...
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1 Dumont P, Denoyer A, Robin P. Long-term results of thoracoscopic sympathectomy for hyperhidrosis. Ann Thorac Surg 2004; 78:1801–7. 2 Gossot D, Galetta D, Pascal A et al. Long-term results of endoscopic thoracic sympathectomy for upper limb hyperhidrosis. Ann Thorac Surg 2003; 75:1075–9. 3 Chang Y-T, Li H-P, Lee J-Y et al. Treatment of palmar hyperhidrosis: T4 Level compared with T3 and T2. An...
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Background and Objective: Primary hyperhidrosis is a common disorder in adolescents and young adults due to the hyperactivity of thoracic sympathetic nerves. This disorder often does not respond to medical treatments. The aim of this study was to evaluate the therapeutic results of uniportal sympathectomy. Materials and Methods: In this retrospective study, all patients with severe hyperhidros...
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Background: Primary hyperhidrosis (PH) refers to excessive sweating, beyond normal physiological levels, in specific sites of the body for unknown reasons. It is usually bilateral and is most prominent in the palms, axillae, feet, and face. PH prevalence is estimated to be 0%-6.1% in different populations. It usually begins in childhood and is more frequent in women. In 57% of ...
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ورودعنوان ژورنال:
- Annals of surgery
دوره 220 1 شماره
صفحات -
تاریخ انتشار 1994