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Objective evaluation of plantar hyperhidrosis after sympathectomy.

AbstractOBJECTIVE:
The aim of the present study was to prospectively, randomly, blindly, and objectively investigate how surgery affects plantar sudoresis in patients with palmar and plantar hyperhidrosis over a one-year period using a sudorometer (VapoMeter).
METHODS:
From February 2007 to May 2009, 40 consecutive patients with combined palmar hyperhidrosis and plantar hyperhidrosis underwent video-assisted thoracic sympathectomy at the T3 or T4 ganglion level (15 women and 25 men, with a mean age of 25 years).
RESULTS:
Immediately after the operation and during the one-year follow-up, all of the patients were free from palmar hyperhidrosis episodes. Compensatory hyperhidrosis of varying degrees was observed in 35 (87.5%) patients after one year. Only two (2.5%) patients suffered from severe compensatory hyperhidrosis. There was a large initial improvement in plantar hyperhidrosis in 46.25% of the cases, followed by a progressive regression of that improvement, such that only 30% continued to show this improvement after one year. The proportion of patients whose condition worsened increased progressively (from 21.25% to 47.50%), and the proportion of stable patients decreased (32.5% to 22.50%). This was not related to resection level; however, a lower intensity of plantar hyperhidrosis prior to sympathectomy correlated with worse evolution.
CONCLUSION:
Patients with palmar hyperhidrosis and plantar hyperhidrosis who underwent video-assisted thoracic sympathectomy to treat their palmar hyperhidrosis exhibited good initial improvement in plantar hyperhidrosis, which then decreased to lesser degrees of improvement over a one-year period following the surgery. For this reason, video-assisted thoracic sympathectomy should not be performed when only plantar hyperhidrosis is present.
AuthorsNelson Wolosker, Augusto Ishy, Guilherme Yazbek, Jose Ribas Milanez de Campos, Paulo Kauffman, Pedro Puech-Leão, Fabio Biscegli Jatene
JournalClinics (São Paulo, Brazil) (Clinics (Sao Paulo)) Vol. 68 Issue 3 Pg. 311-5 ( 2013) ISSN: 1980-5322 [Electronic] Brazil
PMID23644849 (Publication Type: Journal Article, Randomized Controlled Trial)
Topics
  • Adolescent
  • Adult
  • Analysis of Variance
  • Chi-Square Distribution
  • Female
  • Foot Diseases (surgery)
  • Ganglia, Autonomic (surgery)
  • Hand
  • Humans
  • Hyperhidrosis (surgery)
  • Male
  • Recurrence
  • Sympathectomy (methods)
  • Thoracic Surgery, Video-Assisted (methods)
  • Time Factors
  • Treatment Outcome
  • Young Adult

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